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Babcock MC, Mikulka CR, Wang B, Chandriani S, Chandra S, Xu Y, Webster K, Feng Y, Nelvagal HR, Giaramita A, Yip BK, Lo M, Jiang X, Chao Q, Woloszynek JC, Shen Y, Bhagwat S, Sands MS, Crawford BE. Substrate reduction therapy for Krabbe disease and metachromatic leukodystrophy using a novel ceramide galactosyltransferase inhibitor. Sci Rep 2021; 11:14486. [PMID: 34262084 PMCID: PMC8280112 DOI: 10.1038/s41598-021-93601-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 04/26/2021] [Accepted: 06/25/2021] [Indexed: 11/19/2022] Open
Abstract
Krabbe disease (KD) and metachromatic leukodystrophy (MLD) are caused by accumulation of the glycolipids galactosylceramide (GalCer) and sulfatide and their toxic metabolites psychosine and lysosulfatide, respectively. We discovered a potent and selective small molecule inhibitor (S202) of ceramide galactosyltransferase (CGT), the key enzyme for GalCer biosynthesis, and characterized its use as substrate reduction therapy (SRT). Treating a KD mouse model with S202 dose-dependently reduced GalCer and psychosine in the central (CNS) and peripheral (PNS) nervous systems and significantly increased lifespan. Similarly, treating an MLD mouse model decreased sulfatides and lysosulfatide levels. Interestingly, lower doses of S202 partially inhibited CGT and selectively reduced synthesis of non-hydroxylated forms of GalCer and sulfatide, which appear to be the primary source of psychosine and lysosulfatide. Higher doses of S202 more completely inhibited CGT and reduced the levels of both non-hydroxylated and hydroxylated forms of GalCer and sulfatide. Despite the significant benefits observed in murine models of KD and MLD, chronic CGT inhibition negatively impacted both the CNS and PNS of wild-type mice. Therefore, further studies are necessary to elucidate the full therapeutic potential of CGT inhibition.
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Affiliation(s)
- Michael C Babcock
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Christina R Mikulka
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Bing Wang
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Sanjay Chandriani
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Sundeep Chandra
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Yue Xu
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Katherine Webster
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Ying Feng
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Hemanth R Nelvagal
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Alex Giaramita
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Bryan K Yip
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Melanie Lo
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Xuntian Jiang
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Qi Chao
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Josh C Woloszynek
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Yuqiao Shen
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Shripad Bhagwat
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA
| | - Mark S Sands
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Brett E Crawford
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA, 94949, USA.
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