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Ivanova MM, Dao J, Loynab N, Noor S, Kasaci N, Friedman A, Goker-Alpan O. The Expression and Secretion Profile of TRAP5 Isoforms in Gaucher Disease. Cells 2024; 13:716. [PMID: 38667330 PMCID: PMC11049511 DOI: 10.3390/cells13080716] [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: 02/20/2024] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Gaucher disease (GD) is caused by glucocerebrosidase (GCase) enzyme deficiency, leading to glycosylceramide (Gb-1) and glucosylsphingosine (Lyso-Gb-1) accumulation. The pathological hallmark for GD is an accumulation of large macrophages called Gaucher cells (GCs) in the liver, spleen, and bone marrow, which are associated with chronic organ enlargement, bone manifestations, and inflammation. Tartrate-resistant acid phosphatase type 5 (TRAP5 protein, ACP5 gene) has long been a nonspecific biomarker of macrophage/GCs activation; however, the discovery of two isoforms of TRAP5 has expanded its significance. The discovery of TRAP5's two isoforms revealed that it is more than just a biomarker of macrophage activity. While TRAP5a is highly expressed in macrophages, TRAP5b is secreted by osteoclasts. Recently, we have shown that the elevation of TRAP5b in plasma is associated with osteoporosis in GD. However, the role of TRAP isoforms in GD and how the accumulation of Gb-1 and Lyso-Gb-1 affects TRAP expression is unknown. METHODS 39 patients with GD were categorized into cohorts based on bone mineral density (BMD). TRAP5a and TRAP5b plasma levels were quantified by ELISA. ACP5 mRNA was estimated using RT-PCR. RESULTS An increase in TRAP5b was associated with reduced BMD and correlated with Lyso-Gb-1 and immune activator chemokine ligand 18 (CCL18). In contrast, the elevation of TRAP5a correlated with chitotriosidase activity in GD. Lyso-Gb-1 and plasma seemed to influence the expression of ACP5 in macrophages. CONCLUSIONS As an early indicator of BMD alteration, measurement of circulating TRAP5b is a valuable tool for assessing osteopenia-osteoporosis in GD, while TRAP5a serves as a biomarker of macrophage activation in GD. Understanding the distinct expression pattern of TRAP5 isoforms offers valuable insight into both bone disease and the broader implications for immune system activation in GD.
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Affiliation(s)
- Margarita M. Ivanova
- Lysosomal and Rare Disorders Research and Treatment Center, Fairfax, VA 22030, USA; (J.D.); (N.K.); (O.G.-A.)
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Komninaka V, Flevari P, Karkaletsis G, Androutsakos T, Karkaletsi T, Ntanasis-Stathopoulos I, Ntelaki EE, Terpos E. Gaucher-like Cells in Thalassemia Intermedia: Is It a Challenge? Diseases 2023; 11:161. [PMID: 37987272 PMCID: PMC10660717 DOI: 10.3390/diseases11040161] [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: 10/07/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
We describe two cases of thalassemia intermedia (TI) patients with the presence of Gaucher-like cells in hematopoietic tissue biopsies, raising diagnostic dilemmas. The first is a 56-year-old female with bone lesions, splenomegaly, hypochromic microcytic anemia and Gaucher-like cells in the bone marrow, with a final diagnosis of TI, and the second is a 69-year-old male with TI, monoclonal gammopathy of undetermined significance (MGUS) that accelerated to multiple myeloma (MM) requiring treatment, bone disease and Gaucher-like cells in the bone marrow and the spleen, and heterozygoty of Gaucher disease (GD). Gaucher-like cells are difficult to differentiate from true Gaucher cells, that are the hallmark of GD suspicion. These cells are usually reported in the lymphohematopoietic system. They have been described in myeloproliferative disorders, hematological malignancies, infectious diseases, hemoglobinopathies and other hemolytic anemias. The presence of Gaucher-like cells in patients with thalassemia major has been well documented, whereas there are limited references regarding cases with thalassemia intermedia. The identification of these cells in thalassemia probably reflects the high cell turnover. The bony complications in GD and TIare not yet fully explained in the literature, and this raises the question of whether Gaucher-like cells could play a pathogenetic role in the bone disease of thalassemia, as Gaucher cells are considered to play a similar role in bone complications of GD. Moreover, given the rarity and similarity of Gaucher and Gaucher-like cells, we would like to highlight that the presence of Gaucher-like cells in the bone marrow should not be overlooked, as they might be obscuring an underlying pathology, in order to ensure that hematologists, internists and hematopathologists will be promptly and accurately diagnosed.
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Affiliation(s)
- Veroniki Komninaka
- Centre of Excellence in Rare Haematological (Haemoglobinopathies) & Rare Metabolic (Gaucher Disease) Diseases, Laiko General Hospital, 11527 Athens, Greece (P.F.)
| | - Pagona Flevari
- Centre of Excellence in Rare Haematological (Haemoglobinopathies) & Rare Metabolic (Gaucher Disease) Diseases, Laiko General Hospital, 11527 Athens, Greece (P.F.)
| | - Georgios Karkaletsis
- Medical School, Otto von Guericke University Magdeburg (OVGU), 39120 Magdeburg, Germany
| | - Theodoros Androutsakos
- Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Theofili Karkaletsi
- Medical School, Charité—Berlin University of Medicine, 10117 Berlin, Germany
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Evaggelia-Eleni Ntelaki
- Centre of Excellence in Rare Haematological (Haemoglobinopathies) & Rare Metabolic (Gaucher Disease) Diseases, Laiko General Hospital, 11527 Athens, Greece (P.F.)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
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Bouayadi O, Lyagoubi A, Aarab A, Lamrabat S, Berhili A, Bensalah M, Seddik R. Gaucher Disease: An Underdiagnosed Pathology in the Eastern Moroccan Population. EJIFCC 2019; 30:82-87. [PMID: 30881277 DOI: pmid/30881277] [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] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Gaucher disease (GD) is a lysosomal storage disease. It corresponds to a congenital deficit in β-glucocerebrosidase. This pathology should be considered in the presence of unexplained splenomegaly, with or without signs of haemorrhage, skeletal manifestations or hepatomegaly. The diagnosis is based on the measurement of the β-glucocerebrosidase activity but the preanalytical process should be respected in order to avoid the under-diagnosis of this disorder and the delay of its management. We report two cases of Gaucher disease collected at Mohammed VI University Hospital and Al Farabi regional hospital in Oujda. We have emphasized the need for a reference center for overload diseases.
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Affiliation(s)
- Ouardia Bouayadi
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed the First University, Oujda, Morocco
| | - Amina Lyagoubi
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed the First University, Oujda, Morocco
| | - Adnane Aarab
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed the First University, Oujda, Morocco
| | - Somiya Lamrabat
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed the First University, Oujda, Morocco
| | - Abdelilah Berhili
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco
| | - Mohammed Bensalah
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed the First University, Oujda, Morocco
| | - Rachid Seddik
- Laboratory of Hematology, Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed the First University, Oujda, Morocco
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Zinovkin DA, Pranjol MZI, Kravchenko D, Kravchenko O, Kudryashov V. Gaucher Disease Involving Virchow's Lymph Node: a Case Report. Folia Med (Plovdiv) 2018; 60:647-50. [PMID: 31188768 DOI: 10.2478/folmed-2018-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/22/2018] [Indexed: 11/20/2022] Open
Abstract
Gaucher disease is a metabolic storage disorder caused by a mutation in the lysosomal enzyme B-glucocerebrosidase. This disease is usually manifested in new born infants, however, an exceptional case of this disease in adult has been recently reported. A 21-year-old Caucasian patient was diagnosed with Gaucher disease, demonstrating Virchow's lymphatic node enlargement and mild splenomegaly. A familial link to this disease was also found. Macrophage infiltration was observed in the aff ected Virchow's lymph node which is not a classic sign of Gaucher disease. DNA analysis and a whole blood count also suggested a manifestation of this disease. In summary, this is the first study to report such case of Gaucher disease in an adult female patient, which may suggest an asymptomatic characteristic of this condition and an importance of the presence of Gaucher cells in the enlarged Virchow's lymph node.
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Abstract
A 38-year-old female patient was diagnosed with anemia for 3 years. Medical examination showed slight splenomegaly (250 × 62 mm), thrombocytopenia (platelets 51 × 109/L), anemia (Hb levels 107 g/L), and β-glucocerebrosidase activity (GBA) in leukocytes was lower than normal. Microscopic findings of bone marrow smear demonstrated that Gaucher cells in bone marrow and periodic acid-Schiff staining of them were positive. Sequencing of GBA genomic and cDNA identified one novel homozygous mutation, c.484A> G (p.Met162Val). This case suggests that we should pay attention to adult Gaucher disease as a differential diagnosis for cryptogenic thrombocytopenia and one novel homozygous mutation in GBA gene was reported for the first time. The novel mutation in homozygosity is apparently associated with mild, non-neuronopathic type 1 disease which is relatively uncommon in Asian populations.
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Affiliation(s)
- Lagen Wan
- a First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi , People's Republic of China
| | - Hong Wu
- b Jiangxi Province Blood Center , Nanchang , Jiangxi , People's Republic of China
| | - Fuyuan Xie
- a First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi , People's Republic of China
| | - Yijun Nie
- a First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi , People's Republic of China
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Chatterjee T, Dewan K, Ganguli P, Das S, Sharma A, Sahni AK, Nath P. A Rare Case of Hemoglobin E Hemoglobinopathy with Gaucher's Disease. Indian J Hematol Blood Transfus 2014; 29:110-2. [PMID: 24426351 DOI: 10.1007/s12288-012-0153-z] [Citation(s) in RCA: 3] [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: 11/25/2011] [Accepted: 03/21/2012] [Indexed: 10/28/2022] Open
Abstract
Hemoglobin (Hb) E mutation is common in north-east part of our country. The natural history of Hb E thalassemia is highly variable. The phenotype, for patients with similar mutations, can range from asymptomatic to transfusion dependent. Our patient presented at 2 years of age with failure to thrive and hepatosplenomegaly. Routine work up revealed microcytic, hypochromic red blood cells. Hb E homozygous was indicated on electrophoresis and hemoglobin HPLC. Evaluation of parents revealed Haemoglobin E trait in both. Therapeutic splenectomy revealed Gaucher-like cells. β-Glucocerebrosidase levels were low. Presence of Gaucher-like cells with normal β-glucocerebrosidase (pseudo-Gaucher cells) are known in leukemia, multiple myeloma, thalassemia and mycobacterial infections. Co-existence of Gaucher's disease with Hb E mutation is not reported to the best of our knowledge.
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Affiliation(s)
| | | | - P Ganguli
- Army Hospital R and R, Delhi Cantt, India
| | | | | | - A K Sahni
- Army Hospital R and R, Delhi Cantt, India
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Lebel E, Elstein D, Peleg A, Reinus C, Zimran A, Amir G. Histologic findings of femoral heads from patients with Gaucher disease treated with enzyme replacement. Am J Clin Pathol 2013; 140:91-6. [PMID: 23765538 DOI: 10.1309/ajcpfvsaego67ngt] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To assess correlations of patient demographics, including enzyme replacement therapy (ERT) with bone histology, to facilitate decisions of whether and when to perform hip replacement surgery in patients with Gaucher disease. METHODS We examined the histology of surgically removed femoral heads and categorized findings by the presence or extent of osteonecrosis, Gaucher cell (GC) infiltration, and bone regeneration qualifiers using a tripartite histology-based scoring system. RESULTS Twenty-two patients with 26 bone specimens were evaluated. Seventeen patients (77%) were splenectomized, 16 (73%) received ERT, and 12 (55%) had the putatively milder genotype (N370S/N370S), with the rest putatively at increased risk for skeletal disease (N370S/other). The 3 histology subscores were applicable to all specimens. Osteonecrotic bone was seen in 19 of 26 (73%); osteoarthritis was seen in all cartilage specimens. Gaucher cell infiltration was not correlated with demographics or disease severity. A trend was noted between reduced GC infiltration and ERT (ρ = 0.407), but regeneration qualifiers were not correlated with ERT or other features. CONCLUSIONS Histologic findings of GC infiltration and bone regeneration qualifiers did not correlate with demographics or with exposure to ERT. Most specimens unexpectedly showed good regenerative responses to osteonecrosis despite heavy GC infiltration.
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Affiliation(s)
- Ehud Lebel
- Department of Orthopedic Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Deborah Elstein
- Gaucher Clinic, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ariel Peleg
- Gaucher Clinic, Shaare Zedek Medical Center, Jerusalem, Israel
| | | | - Ari Zimran
- Gaucher Clinic, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Gail Amir
- Department of Pathology, Hadassah Medical Center, Ein-Karem, Israel
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Adas M, Adas G, Karatepe O, Altiok M, Ozcan D. Gaucher's disease diagnosed by splenectomy. N Am J Med Sci 2009; 1:134-6. [PMID: 22666685 PMCID: PMC3364643] [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: 11/30/2022]
Abstract
CONTEXT Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. CASES Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. CONCLUSIONS For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation.
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Affiliation(s)
- Mine Adas
- Department of Endocrinology, Okmeydani Training Hospital, Istanbul, Turkey
| | - Gokhan Adas
- Department of General Surgery, Okmeydani Training Hospital, Istanbul, Turkey
| | - Oguzhan Karatepe
- Department of General Surgery, Okmeydani Training Hospital, Istanbul, Turkey
| | - Merih Altiok
- Department of General Surgery, Okmeydani Training Hospital, Istanbul, Turkey
| | - Deniz Ozcan
- Department of Pathology, Okmeydani Training Hospital, Istanbul, Turkey
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