DOCSLIB.ORG

Morphologic Changes in the Nervous System in Gaucher's Disease, GM2

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Morphologic Changes in the Nervous System in Gaucher's Disease, GM2 ANNALS OF C LINICAL AND LABORATORY SCIEN CE, Vol. 5, No. 6 Copyright © 1975, Institute for Clinical Science The Lipidoses: Morphologic Changes in the Nervous System in Gaucher’s Disease, GM2 Gandliosidoses and Niemann-Pick Disease JAMES B. AREY, M.D., Ph.D. St. Christopher’s Hospital for Children, Department of Pediatrics and Pathology, Temple University School of Medicine, Philadelphia, PA. 19140 ABSTRACT The present paper presents, in tabular form, most of the inborn errors of lipid metabolism (exclusive of the hyperlipoproteinemias); some may, with further studies, be removed from this category. Three of the lipidoses and their subtypes which are associated with severe neurologic disorders are discussed, i.e., infantile Gaucher’s disease, Niemann-Pick disease and the GM2 gangliosidoses. Particular emphasis is placed on the importance of careful biochemical and enzymatic studies of either surgical or autopsy material of any patient suspected of having one of the lipidoses. Only by such studies can an exact diagnosis of virtually all of these inborn errors of lipid metabolism be established. Such a diagnosis is im­ portant, since in many instances an antenatal diagnosis is possible by demon­ stration of the enzymatic defect in cells grown in tissue culture from the amniotic fluid. Introduction cludes their normal catabolic cycle; the nature of many of these enzymatic defects The lipidoses, here defined as inborn er­ has been elucidated only within the past 5 to rors of metabolism characterized by an in­ 10 years and can often be demonstrated not crease of one or more lipids in the tissues, only in the tissues in which the major mor­ and sometimes in the plasma as well, are phologic changes are present but also in usually transmitted as autosomal recessive other viscera, in circulating leukocytes, in characteristics, with only the homozygously fibroblasts grown in tissue culture and in involved person having the overt disease. cells grown from tissue cultures of amniotic Fabry’s disease, which will not be discussed fluid. Thus, an antenatal diagnosis of many further in this paper, is, however, transmit­ of the lipidoses is now possible. In table I is ted by an X-linked mode of inheritance. an incomplete listing of the lipidoses, only a Many of the lipidoses are associated with few of which will be discussed in this severe mental and motor retardation, some­ manuscript. In some of those included in this times accompanied by blindness. The stored tabulation, the nature of the enzymatic de­ lipid(s) are generally ones normally present fect is currently unknown and in some, e.g., in the body which have accumulated as the Farber’s disease, the nature of the stored result of an enzymatic defect which pre­ substances is not entirely clear. Thus, it is 4 7 6 AREY TABLE I vertebral bodies, or pain, limp and limitation The Lipidoses of motion, sometimes followed by os­ teoarthrosis as a result of destruction of the Gaucher's disease femoral head. Since it is not accompanied by Infantile or cerebral Adult or non-cerebral neurologic manifestations, it will not be dis­ Tay-Sachs disease (GM2 gangliosidosis type 1) Sandhoff's disease (GM2 gangliosidosis type 2) cussed further here, except as to its enzy­ Juvenile GM2 gangliosidosis (GM2 gangliosidosis matic relationship to the infantile form of type 3) GM^ gangliosidosis type I (Landing's disease: Gaucher’s disease. pseudo-Hurler's disease) Acute, infantile or cerebral Gaucher’s GM^ gangliosidosis type II (juvenile GM^ ganglio­ sidosis; Derry's disease) disease has no predilection for Jews. It is a Niemann-Pick disease Classical infantile form (Group A) very rare disorder characterized by the early Non-cerebral form (Group B) onset of impaired mental and motor de­ Late infantile form (Group C) Nova Scotian form (Group D) velopment, prominent neurologic manifes­ Fabry-Anderson disease (angiokeratoma corporis diffusum) tations and abdominal enlargement second­ Globoid cell leukodystrophy (Krabbe’s disease) ary to hepatosplenomegaly. Hyperextension Metachromatic leukodystrophy (sulfatide leuko­ dystrophy) of the neck, strabismus, hypertonicity, dys­ Late infantile phagia, apathy or somnolence with cata­ Juvenile Adult tonia, increased deep tendon reflexes and "Variant" form Refsum's disease (phytanic acid storage disease) laryngeal spasm are among the more com­ Cholesteryl ester storage disease mon neurologic manifestations. These Cerebrotendinous xanthomatosis Tangier disease (familial high density lipoprotein usually appear by the age of six months and, deficiency) Abetalipoproteinemia (Bassen-Kornzweig syndrome) rarely, some may be present at birth. There Wolman's disease may be microcytic anemia as well as Sudanophilic leukodystrophy Farber's disease thrombocytopenia. The serum acid phos­ phatase is increased, most of it being non- tartrate-inhibitable. Increased amounts of glucosylceramide are present in the urinary quite possible that some of those here tabu­ sediment.5 Roentgen examination of the lated may be subsequently removed from chest often reveals a hazy reticular or coarse, the classification of lipidoses. miliary-like pattern. Aspirates of the bone marrow almost always reveal typical Gaucher’s Disease Gaucher cells, the morphology of which is Gau cher’s disease is characterized by the indistinguishable from that encountered in accumulation of glucocerebrosides in the the adult, non-cerebral form of the disease. cells of the reticuloendothelial system. In­ The disease is usually rapidly fatal, most of frequently, presumably similar deposits have the patients dying by the age of one year. been identified in neurons in the central Thanatopsy reveals severe splenomegaly, nervous system in infants with the cerebral the weight of the spleen often being ten or (infantile) form of the disease.1 more times that expected. The liver is simi­ Chronic, non-cerebral or the adult form of larly but not so massively enlarged. His­ Gaucher’s disease, which accounts for at tologically large numbers of Gaucher cells least 80 percent of the recorded instances of are present in the reticuloendothelial cells of this disorder, involves principally Ashkenazi the spleen, liver, bone marrow, lymph Jews. Its manifestations are predominantly nodes, tonsils, thymus and Peyer’s patches. those of hypersplenism and osseous changes, In the lungs, similar cells may be present e.g., vague pains in the bones, sharply lo­ both in the alveolar septa and spaces. These calized pain as the result of pathologic frac­ cells, in contrast to most of the lipidoses, are tures, kyphosis secondary to collapse of not vacuolated, but instead tend to have a LIPIDOSES: MORPHOLOGIC CHANGES IN NERVOUS SYSTEM 4 7 7 Figure 1. Infantile Gau­ cher s disease. Section of the thymus reveals a Hassell’s corpuscle on the right and Gaucher cells with a fibrillary type of cy­ toplasm on the left. Pe­ riodic acid Schiff x 390. fibrillary type of cytoplasm (figure 1). They cells may be present in the leptomeninges are large, pale cells, 20 to 100 micra in and in Virchow-Robin spaces. diameter, with one or more dark, ec­ The enzymatic defect responsible for the centrically placed nuclei. The fibrillary cyto­ adult or noncerebral and the infantile or ce­ plasm stains a bright rose purple by the pe­ rebral form of Gaucher’s disease is qualita­ riodic acid leukofuchsin (Schiff) technique tively similar. In the adult form, glucocere- following fixation in formalin and embed­ brosidase activity is present but is greatly ding in paraffin as well as after freeze reduced, whereas in the infantile form it is drying.16 virtually absent. The two diseases, neverthe­ In spite of the prominent neurologic less, appear to be distinct entities, and adults manifestations, specific changes in the with Gaucher’s disease do not give birth to central nervous system are often absent. infants with the acute, cerebral form of the There is, however, usually widespread de­ disease. Heterozygous carriers may be de­ generation of neurons with chromatolysis tected by enzyme assays performed on ex­ and neuronophagia and, by electron mi­ tracts of skin fibroblasts grown in tissue cul­ croscopy, “ Gaucher bodies” are sometimes ture as well as upon sonicated white blood identifiable in the cytoplasm of the shrunken cell preparations;2 heterozygous carriers of neurons.1 Small accumulations of Gaucher the adult form of the disease may also be de­ 4 7 8 AREY tected by the demonstration in tissue cul­ present in the neonatal period but may al­ tures of the skin of giant fibroblasts con­ ready be visible by the second month of taining metachromatic material.4 life.26 It is present at some time in the course of the disease in almost all of the patients but may disappear when the disease Tay-Sachs Disease is prolonged. The infant becomes flaccid Tay-Sachs disease (GM2 gangliosidosis with increased reflexes and obvious Type I) was initially described in 1881 by blindness, followed by increasing dementia, Waren Tay, a British ophthalmologist.32 In intense spasticity with greatly increased 1884, he noted the occurrence of the disease reflexes, extensor plantar responses and in two siblings of the infant first reported by seizures. A completely vegetative state is him33 and in 1892 he reported a fourth finally reached, with death usually occurring instance of the same disease in a different by three or four years of age. family.34 Sachs, a New York neurologist, Although the measurements of the head described the clinical and pathologic find­ are initially normal, in patients surviving ings in a child with this disease in 188723 and more than 18 to 24 months after the onset of in 1896 designated the illness as amaurotic symptoms there is usually a progressive in­ family idiocy.24 Prior to this last report, crease in its size, its circumference at the however, Kingdon11 in 1892 had reported an time of death often being about 20 percent additional patient and had collected from above normal. This is not primarily the re­ the literature6,8,12'15,23,35 and from personal sult of hydrocephalus, although initially correspondence 10 to 12 infants and young there may be slight dilation of the lateral children with the disease, including the one and of the fourth ventricles.
Load more

Recommended publications
  • Sphingolipid Metabolism Diseases ⁎ Thomas Kolter, Konrad Sandhoff
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Biochimica et Biophysica Acta 1758 (2006) 2057–2079 www.elsevier.com/locate/bbamem Review Sphingolipid metabolism diseases ⁎ Thomas Kolter, Konrad Sandhoff Kekulé-Institut für Organische Chemie und Biochemie der Universität, Gerhard-Domagk-Str. 1, D-53121 Bonn, Germany Received 23 December 2005; received in revised form 26 April 2006; accepted 23 May 2006 Available online 14 June 2006 Abstract Human diseases caused by alterations in the metabolism of sphingolipids or glycosphingolipids are mainly disorders of the degradation of these compounds. The sphingolipidoses are a group of monogenic inherited diseases caused by defects in the system of lysosomal sphingolipid degradation, with subsequent accumulation of non-degradable storage material in one or more organs. Most sphingolipidoses are associated with high mortality. Both, the ratio of substrate influx into the lysosomes and the reduced degradative capacity can be addressed by therapeutic approaches. In addition to symptomatic treatments, the current strategies for restoration of the reduced substrate degradation within the lysosome are enzyme replacement therapy (ERT), cell-mediated therapy (CMT) including bone marrow transplantation (BMT) and cell-mediated “cross correction”, gene therapy, and enzyme-enhancement therapy with chemical chaperones. The reduction of substrate influx into the lysosomes can be achieved by substrate reduction therapy. Patients suffering from the attenuated form (type 1) of Gaucher disease and from Fabry disease have been successfully treated with ERT. © 2006 Elsevier B.V. All rights reserved. Keywords: Ceramide; Lysosomal storage disease; Saposin; Sphingolipidose Contents 1. Sphingolipid structure, function and biosynthesis ..........................................2058 1.1.
    [Show full text]
  • Attenuation of Ganglioside GM1 Accumulation in the Brain of GM1 Gangliosidosis Mice by Neonatal Intravenous Gene Transfer
    Gene Therapy (2003) 10, 1487–1493 & 2003 Nature Publishing Group All rights reserved 0969-7128/03 $25.00 www.nature.com/gt RESEARCH ARTICLE Attenuation of ganglioside GM1 accumulation in the brain of GM1 gangliosidosis mice by neonatal intravenous gene transfer N Takaura1, T Yagi2, M Maeda2, E Nanba3, A Oshima4, Y Suzuki5, T Yamano1 and A Tanaka1 1Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan; 2Department of Neurobiology and Anatomy, Osaka City University Graduate School of Medicine, Osaka, Japan; 3Gene Research Center, Tottori University, Yonago, Japan; 4Department of Pediatrics, Takagi Hospital, Saitama, Japan; and 5Pediatrics, Clinical Research Center, Nasu Institute for Developmental Disabilities, International University of Health and Welfare, Ohtawara, Japan A single intravenous injection with 4 Â 107 PFU of recombi- ganglioside GM1 was above the normal range in all treated nant adenovirus encoding mouse b-galactosidase cDNA to mice, which was speculated to be the result of reaccumula- newborn mice provided widespread increases of b-galacto- tion. However, the values were still definitely lower in most of sidase activity, and attenuated the development of the the treated mice than those in untreated mice. In the disease including the brain at least for 60 days. The b- histopathological study, X-gal-positive cells, which showed galactosidase activity showed 2–4 times as high a normal the expression of exogenous b-galactosidase gene, were activity in the liver and lung, and 50 times in the heart. In the observed in the brain. It is noteworthy that neonatal brain, while the activity was only 10–20% of normal, the administration via blood vessels provided access to the efficacy of the treatment was distinct.
    [Show full text]
  • GM2 Gangliosidoses: Clinical Features, Pathophysiological Aspects, and Current Therapies
    International Journal of Molecular Sciences Review GM2 Gangliosidoses: Clinical Features, Pathophysiological Aspects, and Current Therapies Andrés Felipe Leal 1 , Eliana Benincore-Flórez 1, Daniela Solano-Galarza 1, Rafael Guillermo Garzón Jaramillo 1 , Olga Yaneth Echeverri-Peña 1, Diego A. Suarez 1,2, Carlos Javier Alméciga-Díaz 1,* and Angela Johana Espejo-Mojica 1,* 1 Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; lealb.af@javeriana.edu.co (A.F.L.); elianabenincore@javeriana.edu.co (E.B.-F.); aura.solano@javeriana.edu.co (D.S.-G.); rafael.garzon@javeriana.edu.co (R.G.G.J.); oyecheve@javeriana.edu.co (O.Y.E.-P.); suarezd.i@javeriana.edu.co (D.A.S.) 2 Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 110231, Colombia * Correspondence: cjalmeciga@javeriana.edu.co (C.J.A.-D.); aespejo@javeriana.edu.co (A.J.E.-M.); Tel.: +57-1-3208320 (ext. 4140) (C.J.A.-D.); +57-1-3208320 (ext. 4099) (A.J.E.-M.) Received: 6 July 2020; Accepted: 7 August 2020; Published: 27 August 2020 Abstract: GM2 gangliosidoses are a group of pathologies characterized by GM2 ganglioside accumulation into the lysosome due to mutations on the genes encoding for the β-hexosaminidases subunits or the GM2 activator protein. Three GM2 gangliosidoses have been described: Tay–Sachs disease, Sandhoff disease, and the AB variant. Central nervous system dysfunction is the main characteristic of GM2 gangliosidoses patients that include neurodevelopment alterations, neuroinflammation, and neuronal apoptosis. Currently, there is not approved therapy for GM2 gangliosidoses, but different therapeutic strategies have been studied including hematopoietic stem cell transplantation, enzyme replacement therapy, substrate reduction therapy, pharmacological chaperones, and gene therapy.
    [Show full text]
  • Hyperglycopeptiduria in Genetic Mucolipidoses
    Tohoku J. exp. Med., 1974, 112, 373-380 Hyperglycopeptiduria in Genetic Mucolipidoses TADAO ORII, TAKAMICHI CHIBA, RYOJI MINAMI, KAZUKO S UKEGAWA and TooRu NAKAO Department of Pediatrics, Sapporo Medical College, Sapporo ORII, T., CHmA, T., MINAMI, R., SUKEUAWA,K. and NAKAO, T. Hyper glycopeptiduria in Genetic Mucolipidoses. Tohoku J. exp. Med., 1974, 112 (4), 373-380 -Urinary cetylpyridinium chloride (CPC)-precipitates and non-CPC- precipitates in normal male children and seven patients with a new type of mucolipidosis, GM1-gangliosidosis type 1, I-cell disease, Hurler syndrome, Morquio syndrome, Gaucher's disease adult type and Tay-Sachs disease were studied using several methods including Sephadex G-25 gel filtration, ECTEOLA-cellulose column chromatography and enzymatic digestion with chondroitinase ABC. 1) Considerable amounts of glycopeptide fractions were detected in the urine of the patients with a new type of mucolipidosis, Gm1-gangliosidosis type 1, I-cell disease and also Gaucher's disease adult type compared with that of normal male children and other patients. 2) The total acid mucopolysaccharides excreted into the urine from two patients with Hurler syndrome and Morquio syndrome were much higher than those excreted in normal male children and other patients. 3) Large amounts of the chondroitinase ABC-resistant acid mucopolysaccharides were found in the urine of patients with Hurler syndrome, Morquio syndrome and Gm,-gangliosidosis type 1. mucolipidoses; glycopeptiduria; Gaucher's disease A group of storage disease which exhibits signs and symptoms of both mucopolysaccharidoses and sphingolipidoses has tentatively been classified as the mucolipidoses by Spranger and Wiedemann (1970). With the exception of the Austin type of sulfatidosis, it has been reported by several workers that the patients with mucolipidosis generally show normal urinary excretion of uronic acid-containing mucopolysaccharides.
    [Show full text]
  • The Nature of Mutation in Krabbe Disease
    Am J Hum Genet 30:644-652, 1978 The Nature of Mutation in Krabbe Disease YOAV BEN-YOSEPH,1 MELINDA HUNGERFORD, AND HENRY L. NADLER Krabbe disease (globoid cell leukodystrophy) is a disorder of galactolipid metabolism, inherited in an autosomal recessive manner [1]. Onset in early infancy is followed by rapidly progressive degeneration of the central nervous system, ending in death before the age of 2 years. The primary defect has been ascribed to a deficiency of galactosylceramide /3-galactosidase activity [2]. In addition, a deficiency of /3- galactosidase activities towards psychosine (galactosylsphingosine) [3], monogalac- tosyl diglyceride [4], and lactosylceramide [5] have been reported. The inability to degrade these substrates, found in tissues of children who died of Krabbe disease, indicates that the same enzyme may be acting on the four galactolipids. These activities are, however, normal in patients with GM, gangliosidosis. Hydrolysis of lactosyl- ceramide under different assay conditions [6] and /3-galactosidase activities towards GM, ganglioside, asialo-GMl ganglioside, and asialofetuin (ASF) are deficient in GM, gangliosidosis, but normal in Krabbe disease [7]. Thus, the mutation in Krabbe disease is not allelic with the GM, gangliosidosis mutation, and the observation that antibodies to GM, /3-galactosidase do not precipitate the activities of galactosylceramide 38- galactosidase [8, 9] supports the conclusion that these two /3-galactosidase enzymes are different proteins coded by separate loci. The present study defines the nature of the mutation in Krabbe disease. Using antibodies evoked against the normal galactosylceramide ,3-galactosidase enzyme purified from placenta, we found normal quantities of antigenically cross reacting material of the inactive mutant enzyme in brain, liver, and skin fibroblasts of patients with Krabbe disease.
    [Show full text]
  • HHS Public Access Author Manuscript
    HHS Public Access Author manuscript Author Manuscript Author ManuscriptJ Registry Author Manuscript Manag. Author Author Manuscript manuscript; available in PMC 2015 May 11. Published in final edited form as: J Registry Manag. 2014 ; 41(4): 182–189. Exclusion of Progressive Brain Disorders of Childhood for a Cerebral Palsy Monitoring System: A Public Health Perspective Richard S. Olney, MD, MPHa, Nancy S. Doernberga, and Marshalyn Yeargin-Allsopp, MDa aNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC) Abstract Background—Cerebral palsy (CP) is defined by its nonprogressive features. Therefore, a standard definition and list of progressive disorders to exclude would be useful for CP monitoring and epidemiologic studies. Methods—We reviewed the literature on this topic to 1) develop selection criteria for progressive brain disorders of childhood for public health surveillance purposes, 2) identify categories of disorders likely to include individual conditions that are progressive, and 3) ascertain information about the relative frequency and natural history of candidate disorders. Results—Based on 19 criteria that we developed, we ascertained a total of 104 progressive brain disorders of childhood, almost all of which were Mendelian disorders. Discussion—Our list is meant for CP surveillance programs and does not represent a complete catalog of progressive genetic conditions, nor is the list meant to comprehensively characterize disorders that might be mistaken for cerebral
    [Show full text]
  • Mouse Model of GM2 Activator Deficiency Manifests Cerebellar Pathology and Motor Impairment
    Proc. Natl. Acad. Sci. USA Vol. 94, pp. 8138–8143, July 1997 Medical Sciences Mouse model of GM2 activator deficiency manifests cerebellar pathology and motor impairment (animal modelyGM2 gangliosidosisygene targetingylysosomal storage disease) YUJING LIU*, ALEXANDER HOFFMANN†,ALEXANDER GRINBERG‡,HEINER WESTPHAL‡,MICHAEL P. MCDONALD§, KATHERINE M. MILLER§,JACQUELINE N. CRAWLEY§,KONRAD SANDHOFF†,KINUKO SUZUKI¶, AND RICHARD L. PROIA* *Section on Biochemical Genetics, Genetics and Biochemistry Branch, National Institute of Diabetes and Digestive and Kidney Diseases, ‡Laboratory of Mammalian Genes and Development, National Institute of Child Health and Development, and §Section on Behavioral Neuropharmacology, Experimental Therapeutics Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892; †Institut fu¨r Oganische Chemie und Biochemie der Universita¨tBonn, Gerhard-Domagk-Strasse 1, 53121 Bonn, Germany; and ¶Department of Pathology and Laboratory Medicine, and Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599 Communicated by Stuart A. Kornfeld, Washington University School of Medicine, St. Louis, MO, May 12, 1997 (received for review March 21, 1997) ABSTRACT The GM2 activator deficiency (also known as disorder, the respective genetic lesion results in impairment of the AB variant), Tay–Sachs disease, and Sandhoff disease are the the degradation of GM2 ganglioside and related substrates. major forms of the GM2 gangliosidoses, disorders caused by In humans, in vivo GM2 ganglioside degradation requires the defective degradation of GM2 ganglioside. Tay–Sachs and Sand- GM2 activator protein to form a complex with GM2 ganglioside. hoff diseases are caused by mutations in the genes (HEXA and b-Hexosaminidase A then is able to interact with the activator- HEXB) encoding the subunits of b-hexosaminidase A.
    [Show full text]
  • Prevalence of Lysosomal Storage Diseases in Portugal
    European Journal of Human Genetics (2004) 12, 87–92 & 2004 Nature Publishing Group All rights reserved 1018-4813/04 $25.00 www.nature.com/ejhg ARTICLE Prevalence of lysosomal storage diseases in Portugal Rui Pinto1,2, Carla Caseiro1, Manuela Lemos1, Lurdes Lopes1, Augusta Fontes1, Helena Ribeiro1, Euge´nia Pinto1, Elisabete Silva1,So´nia Rocha1, Ana Marca˜o2, Isaura Ribeiro1,2,Lu´cia Lacerda1,2, Gil Ribeiro1,2, Olga Amaral1,2,MCSa´ Miranda*,1,2 1Instituto de Gene´tica Me´dica Jacinto de Magalha˜es, Porto, Portugal; 2Instituto de Biologia Molecular & Celular (IBMC), Portugal Lysosomal storage diseases (LSDs) are a group of inherited metabolic disorders individually considered as rare, and few data on its prevalence has been reported in the literature. The overall birth prevalence of the 29 different LSDs studied in the Portuguese population was calculated to be 25/100 000 live births, twice the prevalence previously described in Australia and in The Netherlands. The comparison of the prevalence profile of the LSDs presenting a prevalence higher than 0.5/100 000 in the Portuguese, Dutch and Australian populations showed, in the Portuguese, the existence of a higher prevalence of GM2 gangliosidoses (B variant), mucolipidoses (II and III), Niemman-Pick type C and metachromatic leukodystrophy (MLD), and a lower prevalence of Pompe and Fabry. The highest prevalence value for a single LSD is the one of GM2 gangliosidoses (B variant), corresponding to 3/100 000, a value which is significantly higher than the prevalence of the most frequent LSD in Dutch, Pompe disease (2/100 000) and Australians, Gaucher’s disease (GD) (1.8/100 000).
    [Show full text]
  • Diagnosis of Metachromatic Leukodystrophy, Krabbe Disease, and Farber Disease After Uptake of Fatty Acid-Labeled Cerebroside Sulfate Into Cultured Skin Fibroblasts
    Diagnosis of Metachromatic Leukodystrophy, Krabbe Disease, and Farber Disease after Uptake of Fatty Acid-labeled Cerebroside Sulfate into Cultured Skin Fibroblasts Tooru Kudoh, David A. Wenger J Clin Invest. 1982;70(1):89-97. https://doi.org/10.1172/JCI110607. Research Article [14C]Stearic acid-labeled cerebroside sulfate (CS) was presented to cultured skin fibroblasts in the media. After endocytosis into control cells 86% was readily metabolized to galactosylceramide, ceramide, and stearic acid, which was reutilized in the synthesis of the major lipids found in cultured fibroblasts. Uptake and metabolism of the [14C]CS into cells from typical and atypical patients and carriers of metachromatic leukodystrophy (MLD), Krabbe disease, and Farber disease were observed. Cells from patients with late infantile MLD could not metabolize the CS at all, while cells from an adult MLD patient and from a variant MLD patient could metabolize ∼40 and 15%, respectively, of the CS taken up. These results are in contrast to the in vitro results that demonstrated a severe deficiency of arylsulfatase A in the late infantile and adult patient and a partial deficiency (21-27% of controls) in the variant MLD patient. Patients with Krabbe disease could metabolize nearly 40% of the galactosylceramide produced in the lysosomes from the CS. This is in contrast to the near zero activity for galactosylceramidase measured in vitro. Carriers of Krabbe disease with galactosylceramidase activity near half normal in vitro and those with under 10% of normal activity were found to metabolize galactosylceramide in cells significantly slower than controls. This provides a method for differentiating affected patients from carriers with low enzyme […] Find the latest version: https://jci.me/110607/pdf Diagnosis of Metachromatic Leukodystrophy, Krabbe Disease, and Farber Disease after Uptake of Fatty Acid-labeled Cerebroside Sulfate into Cultured Skin Fibroblasts TOORU KUDOH and DAVID A.
    [Show full text]
  • EGL Test Description
    2460 Mountain Industrial Boulevard | Tucker, Georgia 30084 Phone: 470-378-2200 or 855-831-7447 | Fax: 470-378-2250 eglgenetics.com GM2-Gangliosidosis AB Variant: GM2A Gene Sequencing Test Code: SGM2A Turnaround time: 4 weeks CPT Codes: 81479 x1 Condition Description The GM2 gangliosidoses (Tay Sachs, Sandhoff, and GM2 gangliosidosis AB variant) are a clinically indistinguishable group of neurodegenerative diseases caused by accumulation of a fatty substance, glycosphingolipid GM2 ganglioside, in the lysosomes. The GM2 gangliosides are normally broken down, in the lysosomes, by the enzyme ?-hexosaminidase A, which is made up of an alpha and a beta subunit, with the help of a cofactor, the GM2 activator protein. The alpha and beta subunits are coded by the genes, HEXA, and HEXB, respectively and the GM2 activator protein is coded by the GM2A gene. Mutations in the HEXA and HEXB genes cause Tay Sachs disease and Sandhoff disease, respectively. These two diseases are distinguished biochemically by enzymatic analysis of ?-hexosaminidase A (a heterodimer of the alpha and beta subunits), that is deficient in Tay Sachs and ?- hexosaminidase B (a homodimer of two beta subunits), that is deficient in Sandhoff’s disease. ?-hexosaminidase A and ?-hexosaminidase B enzyme activities are normal in GM2 gangliosidosis AB variant. Mutations in the GM2A gene (5q33.1) cause the rare GM2 gangliosidosis AB variant (GM2 AB variant) due to the deficiency of the GM2 activator protein and are inherited in an autosomal recessive manner. The clinical course of GM2 AB variant is similar to that of a patient with classic Tay Sachs disease. Disease onset usually occurs after five or six months of age and follows a neurodegenerative course with features including delayed motor milestones, hypotonia, macular cherry red spots, and abnormal MRI findings.
    [Show full text]
  • Consensus Recommendation for a Diagnostic Guideline for Acid Sphingomyelinase Deficiency
    Official journal of the American College of Medical Genetics and Genomics SPECIAL ARTICLE Open Consensus recommendation for a diagnostic guideline for acid sphingomyelinase deficiency Margaret M. McGovern, MD, PhD1, Carlo Dionisi-Vici, MD2, Roberto Giugliani, MD, PhD3, Paul Hwu, MD, PhD4, Olivier Lidove, MD5, Zoltan Lukacs, PhD6, Karl Eugen Mengel, MD7, Pramod K. Mistry, MD, PhD8, Edward H. Schuchman, PhD9 and Melissa P. Wasserstein, MD10 Background: Acid sphingomyelinase deficiency (ASMD) is a rare, base and share personal experience in order to develop a guideline progressive, and often fatal lysosomal storage disease. The underlying for diagnosis of the various ASMD phenotypes. metabolic defect is deficiency of the enzyme acid sphingomyelinase that results in progressive accumulation of sphingomyelin in target Conclusions: Although care of ASMD patients is typically provided tissues. ASMD manifests as a spectrum of severity ranging from rap- by metabolic disease specialists, the guideline is directed at a wide idly progressive severe neurovisceral disease that is uniformly fatal to range of providers because it is important for primary care providers more slowly progressive chronic neurovisceral and chronic visceral (e.g., pediatricians and internists) and specialists (e.g., pulmonolo- forms. Disease management is aimed at symptom control and regular gists, hepatologists, and hematologists) to be able to identify ASMD. assessments for multisystem involvement. Genet Med advance online publication 13 April 2017 Purpose and methods: An
    [Show full text]
  • Disorders of Sphingolipid Synthesis, Sphingolipidoses, Niemann-Pick Disease Type C and Neuronal Ceroid Lipofuscinoses
    551 38 Disorders of Sphingolipid Synthesis, Sphingolipidoses, Niemann-Pick Disease Type C and Neuronal Ceroid Lipofuscinoses Marie T. Vanier, Catherine Caillaud, Thierry Levade 38.1 Disorders of Sphingolipid Synthesis – 553 38.2 Sphingolipidoses – 556 38.3 Niemann-Pick Disease Type C – 566 38.4 Neuronal Ceroid Lipofuscinoses – 568 References – 571 J.-M. Saudubray et al. (Eds.), Inborn Metabolic Diseases, DOI 10.1007/978-3-662-49771-5_ 38 , © Springer-Verlag Berlin Heidelberg 2016 552 Chapter 38 · Disor ders of Sphingolipid Synthesis, Sphingolipidoses, Niemann-Pick Disease Type C and Neuronal Ceroid Lipofuscinoses O C 22:0 (Fatty acid) Ganglio- series a series b HN OH Sphingosine (Sphingoid base) OH βββ β βββ β Typical Ceramide (Cer) -Cer -Cer GD1a GT1b Glc ββββ βββ β Gal -Cer -Cer Globo-series GalNAc GM1a GD1b Neu5Ac βαββ -Cer Gb4 ββ β ββ β -Cer -Cer αβ β -Cer GM2 GD2 Sphingomyelin Pcholine-Cer Gb3 B4GALNT1 [SPG46] [SPG26] β β β ββ ββ CERS1-6 GBA2 -Cer -Cer ST3GAL5 -Cer -Cer So1P So Cer GM3 GD3 GlcCer - LacCer UDP-Glc UDP Gal CMP -Neu5Ac - UDP Gal PAPS Glycosphingolipids GalCer Sulfatide ββ Dihydro -Cer -Cer SO 4 Golgi Ceramide apparatus 2-OH- 2-OH-FA Acyl-CoA FA2H CERS1-6 [SPG35] CYP4F22 ω-OH- ω-OH- FA Acyl-CoA ULCFA ULCFA-CoA ULCFA GM1, GM2, GM3: monosialo- Sphinganine gangliosides Endoplasmic GD3, GD2, GD1a, GD1b: disialo-gangliosides reticulum KetoSphinganine GT1b: trisialoganglioside SPTLC1/2 [HSAN1] N-acetyl-neuraminic acid: sialic acid found in normal human cells Palmitoyl-CoA Deoxy-sphinganine + Serine +Ala or Gly Deoxymethylsphinganine 38 . Fig. 38.1 Schematic representation of the structure of the main sphingolipids , and their biosynthetic pathways.
    [Show full text]