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The National Economic Burden of Rare Disease Study February 2021
Acknowledgements This study was sponsored by the EveryLife Foundation for Rare Diseases and made possible through the collaborative efforts of the national rare disease community and key stakeholders. The EveryLife Foundation thanks all those who shared their expertise and insights to provide invaluable input to the study including: the Lewin Group, the EveryLife Community Congress membership, the Technical Advisory Group for this study, leadership from the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH), the Undiagnosed Diseases Network (UDN), the Little Hercules Foundation, the Rare Disease Legislative Advocates (RDLA) Advisory Committee, SmithSolve, and our study funders. Most especially, we thank the members of our rare disease patient and caregiver community who participated in this effort and have helped to transform their lived experience into quantifiable data. LEWIN GROUP PROJECT STAFF Grace Yang, MPA, MA, Vice President Inna Cintina, PhD, Senior Consultant Matt Zhou, BS, Research Consultant Daniel Emont, MPH, Research Consultant Janice Lin, BS, Consultant Samuel Kallman, BA, BS, Research Consultant EVERYLIFE FOUNDATION PROJECT STAFF Annie Kennedy, BS, Chief of Policy and Advocacy Julia Jenkins, BA, Executive Director Jamie Sullivan, MPH, Director of Policy TECHNICAL ADVISORY GROUP Annie Kennedy, BS, Chief of Policy & Advocacy, EveryLife Foundation for Rare Diseases Anne Pariser, MD, Director, Office of Rare Diseases Research, National Center for Advancing Translational Sciences (NCATS), National Institutes of Health Elisabeth M. Oehrlein, PhD, MS, Senior Director, Research and Programs, National Health Council Christina Hartman, Senior Director of Advocacy, The Assistance Fund Kathleen Stratton, National Academies of Science, Engineering and Medicine (NASEM) Steve Silvestri, Director, Government Affairs, Neurocrine Biosciences Inc. -
Inherited Neuropathies
407 Inherited Neuropathies Vera Fridman, MD1 M. M. Reilly, MD, FRCP, FRCPI2 1 Department of Neurology, Neuromuscular Diagnostic Center, Address for correspondence Vera Fridman, MD, Neuromuscular Massachusetts General Hospital, Boston, Massachusetts Diagnostic Center, Massachusetts General Hospital, Boston, 2 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology Massachusetts, 165 Cambridge St. Boston, MA 02114 and The National Hospital for Neurology and Neurosurgery, Queen (e-mail: [email protected]). Square, London, United Kingdom Semin Neurol 2015;35:407–423. Abstract Hereditary neuropathies (HNs) are among the most common inherited neurologic Keywords disorders and are diverse both clinically and genetically. Recent genetic advances have ► hereditary contributed to a rapid expansion of identifiable causes of HN and have broadened the neuropathy phenotypic spectrum associated with many of the causative mutations. The underlying ► Charcot-Marie-Tooth molecular pathways of disease have also been better delineated, leading to the promise disease for potential treatments. This chapter reviews the clinical and biological aspects of the ► hereditary sensory common causes of HN and addresses the challenges of approaching the diagnostic and motor workup of these conditions in a rapidly evolving genetic landscape. neuropathy ► hereditary sensory and autonomic neuropathy Hereditary neuropathies (HN) are among the most common Select forms of HN also involve cranial nerves and respiratory inherited neurologic diseases, with a prevalence of 1 in 2,500 function. Nevertheless, in the majority of patients with HN individuals.1,2 They encompass a clinically heterogeneous set there is no shortening of life expectancy. of disorders and vary greatly in severity, spanning a spectrum Historically, hereditary neuropathies have been classified from mildly symptomatic forms to those resulting in severe based on the primary site of nerve pathology (myelin vs. -
Pathophysiology of Mucopolysaccharidosis
Pathophysiology of Mucopolysaccharidosis Dr. Christina Lampe, MD The Center for Rare Diseases, Clinics for Pediatric and Adolescent Medicine Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany Inborn Errors of Metabolism today - more than 500 diseases (~10 % of the known genetic diseases) 5000 genetic diseases - all areas of metabolism involved - vast majority are recessive conditions 500 metabolic disorders - individually rare or very rare - overall frequency around 1:800 50 LSD (similar to Down syndrome) LSDs: 1: 5.000 live births MPS: 1: 25.000 live births 7 MPS understanding of pathophysiology and early diagnosis leading to successful therapy for several conditions The Lysosomal Diseases (LSD) TAY SACHS DIS. 4% WOLMAN DIS. ASPARTYLGLUCOSAMINURIA SIALIC ACID DIS. SIALIDOSIS CYSTINOSIS 4% SANDHOFF DIS. 2% FABRY DIS. 7% POMPE 5% NIEMANN PICK C 4% GAUCHER DIS. 14% Mucopolysaccharidosis NIEMANN PICK A-B 3% MULTIPLE SULPH. DEF. Mucolipidosis MUCOLIPIDOSIS I-II 2% Sphingolipidosis MPSVII Oligosaccharidosis GM1 GANGLIOSIDOSIS 2% MPSVI Neuronale Ceroid Lipofuszinois KRABBE DIS. 5% MPSIVA others MPSIII D A-MANNOSIDOSIS MPSIII C MPSIIIB METACHROMATIC LEUKOD. 8% MPS 34% MPSIIIA MPSI MPSII Initial Description of MPS Charles Hunter, 1917: “A Rare Disease in Two Brothers” brothers: 10 and 8 years hearing loss dwarfism macrocephaly cardiomegaly umbilical hernia joint contractures skeletal dysplasia death at the age of 11 and 16 years Description of the MPS Types... M. Hunter - MPS II (1917) M. Hurler - MPS I (1919) M. Morquio - MPS IV (1929) M. Sanfilippo - MPS III (1963) M. Maroteaux-Lamy - MPS IV (1963) M. Sly - MPS VII (1969) M. Scheie - MPS I (MPS V) (1968) M. Natowicz - MPS IX (1996) The Lysosome Lysosomes are.. -
Peripheral Neuropathy in Complex Inherited Diseases: an Approach To
PERIPHERAL NEUROPATHY IN COMPLEX INHERITED DISEASES: AN APPROACH TO DIAGNOSIS Rossor AM1*, Carr AS1*, Devine H1, Chandrashekar H2, Pelayo-Negro AL1, Pareyson D3, Shy ME4, Scherer SS5, Reilly MM1. 1. MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, WC1N 3BG, UK. 2. Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, WC1N 3BG, UK. 3. Unit of Neurological Rare Diseases of Adulthood, Carlo Besta Neurological Institute IRCCS Foundation, Milan, Italy. 4. Department of Neurology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA 5. Department of Neurology, University of Pennsylvania, Philadelphia, PA 19014, USA. * These authors contributed equally to this work Corresponding author: Mary M Reilly Address: MRC Centre for Neuromuscular Diseases, 8-11 Queen Square, London, WC1N 3BG, UK. Email: [email protected] Telephone: 0044 (0) 203 456 7890 Word count: 4825 ABSTRACT Peripheral neuropathy is a common finding in patients with complex inherited neurological diseases and may be subclinical or a major component of the phenotype. This review aims to provide a clinical approach to the diagnosis of this complex group of patients by addressing key questions including the predominant neurological syndrome associated with the neuropathy e.g. spasticity, the type of neuropathy, and the other neurological and non- neurological features of the syndrome. Priority is given to the diagnosis of treatable conditions. Using this approach, we associated neuropathy with one of three major syndromic categories - 1) ataxia, 2) spasticity, and 3) global neurodevelopmental impairment. Syndromes that do not fall easily into one of these three categories can be grouped according to the predominant system involved in addition to the neuropathy e.g. -
Mucopolysaccharidosis Type II: One Hundred Years of Research, Diagnosis, and Treatment
International Journal of Molecular Sciences Review Mucopolysaccharidosis Type II: One Hundred Years of Research, Diagnosis, and Treatment Francesca D’Avanzo 1,2 , Laura Rigon 2,3 , Alessandra Zanetti 1,2 and Rosella Tomanin 1,2,* 1 Laboratory of Diagnosis and Therapy of Lysosomal Disorders, Department of Women’s and Children ‘s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; [email protected] (F.D.); [email protected] (A.Z.) 2 Fondazione Istituto di Ricerca Pediatrica “Città della Speranza”, Corso Stati Uniti 4, 35127 Padova, Italy; [email protected] 3 Molecular Developmental Biology, Life & Medical Science Institute (LIMES), University of Bonn, 53115 Bonn, Germany * Correspondence: [email protected] Received: 17 January 2020; Accepted: 11 February 2020; Published: 13 February 2020 Abstract: Mucopolysaccharidosis type II (MPS II, Hunter syndrome) was first described by Dr. Charles Hunter in 1917. Since then, about one hundred years have passed and Hunter syndrome, although at first neglected for a few decades and afterwards mistaken for a long time for the similar disorder Hurler syndrome, has been clearly distinguished as a specific disease since 1978, when the distinct genetic causes of the two disorders were finally identified. MPS II is a rare genetic disorder, recently described as presenting an incidence rate ranging from 0.38 to 1.09 per 100,000 live male births, and it is the only X-linked-inherited mucopolysaccharidosis. The complex disease is due to a deficit of the lysosomal hydrolase iduronate 2-sulphatase, which is a crucial enzyme in the stepwise degradation of heparan and dermatan sulphate. -
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(19) TZZ¥Z___T (11) EP 3 505 181 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.: 03.07.2019 Bulletin 2019/27 A61K 38/46 (2006.01) C12N 9/16 (2006.01) (21) Application number: 18248241.4 (22) Date of filing: 28.12.2018 (84) Designated Contracting States: (72) Inventors: AL AT BE BG CH CY CZ DE DK EE ES FI FR GB • DICKSON, Patricia GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO Torrance, CA California 90502 (US) PL PT RO RS SE SI SK SM TR • CHOU, Tsui-Fen Designated Extension States: Torrance, CA California 90502 (US) BA ME • EKINS, Sean Designated Validation States: Brooklyn, NY New York 11215 (US) KH MA MD TN • KAN, Shih-Hsin Torrance, CA California 90502 (US) (30) Priority: 28.12.2017 US 201762611472 P • LE, Steven 05.04.2018 US 201815946505 Torrance, CA California 90502 (US) • MOEN, Derek R. (71) Applicants: Torrance, CA California 90502 (US) • Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (74) Representative: J A Kemp Torrance, CA 90502 (US) 14 South Square • Phoenix Nest Inc. Gray’s Inn Brooklyn NY 11215 (US) London WC1R 5JJ (GB) (54) PREPARATION OF ENZYME REPLACEMENT THERAPY FOR MUCOPOLYSACCHARIDOSIS IIID (57) The present disclosure relates to compositions for use in a method of treating Sanfilippo syndrome (also known as Sanfilippo disease type D, Sanfilippo D, mu- copolysaccharidosis type IIID, MPS IIID). The method can entail injecting to the spinal fluid of a MPS IIID patient an effective amount of a composition comprising a re- combinant human acetylglucosamine-6-sulfatase (GNS) protein comprising the amino acid sequence of SEQ ID NO: 1 or an amino acid sequence having at least 90% sequence identity to SEQ ID NO: 1 and having the en- zymatic activity of the human GNS protein. -
Prevalence and Incidence of Rare Diseases: Bibliographic Data
Number 1 | January 2019 Prevalence and incidence of rare diseases: Bibliographic data Prevalence, incidence or number of published cases listed by diseases (in alphabetical order) www.orpha.net www.orphadata.org If a range of national data is available, the average is Methodology calculated to estimate the worldwide or European prevalence or incidence. When a range of data sources is available, the most Orphanet carries out a systematic survey of literature in recent data source that meets a certain number of quality order to estimate the prevalence and incidence of rare criteria is favoured (registries, meta-analyses, diseases. This study aims to collect new data regarding population-based studies, large cohorts studies). point prevalence, birth prevalence and incidence, and to update already published data according to new For congenital diseases, the prevalence is estimated, so scientific studies or other available data. that: Prevalence = birth prevalence x (patient life This data is presented in the following reports published expectancy/general population life expectancy). biannually: When only incidence data is documented, the prevalence is estimated when possible, so that : • Prevalence, incidence or number of published cases listed by diseases (in alphabetical order); Prevalence = incidence x disease mean duration. • Diseases listed by decreasing prevalence, incidence When neither prevalence nor incidence data is available, or number of published cases; which is the case for very rare diseases, the number of cases or families documented in the medical literature is Data collection provided. A number of different sources are used : Limitations of the study • Registries (RARECARE, EUROCAT, etc) ; The prevalence and incidence data presented in this report are only estimations and cannot be considered to • National/international health institutes and agencies be absolutely correct. -
Sanfilippo Disease Type D: Deficiency of N-Acetylglucosamine-6- Sulfate Sulfatase Required for Heparan Sulfate Degradation
Proc. Nat!. Acad. Sci. USA Vol. 77, No. 11, pp. 6822-6826, November 1980 Medical Sciences Sanfilippo disease type D: Deficiency of N-acetylglucosamine-6- sulfate sulfatase required for heparan sulfate degradation (mucopolysaccharidosis/keratan sulfate/lysosomes) HANS KRESSE, EDUARD PASCHKE, KURT VON FIGURA, WALTER GILBERG, AND WALBURGA FUCHS Institute of Physiological Chemistry, Waldeyerstrasse 15, D-4400 Mfinster, Federal Republic of Germany Communicated by Elizabeth F. Neufeld, July 10, 1980 ABSTRACT Skin fibroblasts from two patients who had lippo syndromes and excreted excessive amounts of heparan symptoms of the Sanfilippo syndrome (mucopolysaccharidosis sulfate and keratan sulfate in the urine. His fibroblasts were III) accumulated excessive amounts of hean sulfate and were unable to desulfate N-acetylglucosamine-6-sulfate and the unable to release sulfate from N-acety lucosamine)--sulfate linkages in heparan sulfate-derived oligosaccharides. Keratan corresponding sugar alcohol (17, 18). It was therefore suggested sulfate-derived oligosaccharides bearing the same residue at that N-acetylglucosamine-6-sulfate sulfatase is involved in the the nonreducing end and p-nitrophenyl6sulfo-2-acetamido- catabolism of both types of macromolecules. 2-deoxy-D-ucopyranoside were degraded normally. Kinetic In this paper, we describe a new disease, tentatively desig- differences between the sulfatase activities of normal fibro- nated Sanfilippo disease type D, that is characterized by the blasts were found. These observations suggest that N-acetyl- excessive excretion glucosamine4-6sulfate sulfatase activities degrading heparan clinical features of the Sanfilippo syndrome, sulfate and keratan sulfate, respectively, can be distinguished. of heparan sulfate, and the inability to release inorganic sulfate It is the activity directed toward heparan sulfate that is deficient from N-acetylglucosamine-6-sulfate residues of heparan sul- in these patients; we propose that this deficiency causes Sanfi- fate-derived oligosaccharides. -
Journal of Inborn Errors of Metabolism & Screening
Original Article Journal of Inborn Errors Determination of Reference Values for of Metabolism & Screening 2021, Volume 9: e20200023 Alpha-N-Acetylglucosaminidase Activities DOI: https://doi.org/10.1590/2326–4594– JIEMS–2020–0023 in Patients with Sanfilippo Type B Disease and Control Population in Colombia Johana Ramírez Borda1 and Alfredo Uribe-Ardila1 Abstract Sanfilippo B is a lysosomal disorder characterized by the pathological accumulation of heparan sulfate. It is caused by mutations in the NAGLU gene that codes for the alpha-N-acetylglucosaminidase enzyme. The objective of this study was to determine the reference values and frequency of Sanfilippo B in Colombia through an enzyme analysis of leukocytes extracts. We aim to inform the community and the health system so that they can work in a preventive way, providing an early diagnosis of patients and thus providing an appropriate management of the symptoms. We carried out an endpoint assay that indirectly quantifies NAGLU activity through the cleavage of 4-methylumbelliferone from the 4-methylumbelliferyl-2-acetamido-2-deoxy-α-D-glucopyranoside substrate. The activity of 463 healthy volunteers (Range: 0.6 - 4 nmol/mg/h , Median: 1.69 +/- 0.73 ) as well as 462 patients referred for clinical suspicion, was calculated. From the last group, 7 cases turned out to be positive (Range: 0 - 0.24 nmol/mg/h , Median: 0.13 +/- 0.09 ). The cut-off point according to ROC analysis between affected patients and controls was 0.42 nmol/mg/h. To our knowledge, this study is the first in Colombia where an estimated frequency of Sanfilippo type B is calculated by providing enzyme activity ranges and a cut-off point. -
Giant Axonal Neuropathy
Proc. Nati. Acad. Sci. USA Vol. 82, pp. 920-924, February 1985 Neurobiology Giant axonal neuropathy: Acceleration of neurofilament transport in optic axons (axonal morphometry/fluorography/2,5-hexanedione/intermediate filaments/i proteins) SALVATORE MONACO, LUCILA AUTILIO-GAMBETTI, DAVID ZABEL, AND PIERLUIGI GAMBETTI* Division of Neuropathology, Institute of Pathology, Case Western Reserve University, Cleveland, OH 44106 Communicated by George B. Koelle, September 4, 1984 ABSTRACT Giant axonal neuropathies are a group of ac- ane are widely used as solvents and have caused outbreaks quired and inherited human diseases morphologically charac- of polyneuropathies among industrial workers (11, 12) and in terized by accumulation of neurofilaments (NF) in enlarge- individuals intentionally inhaling glue vapors (13). The distal ments of preterminal regions of central and peripheral axons. giant axonopathy produced by these compounds in experi- Slow axonal transport was studied in the optic systems of rats mental and clinical conditions is indistinguishable from that treated with 2,5-hexanedione, a toxic compound that produces of the inherited forms (4). an experimental model of giant axonal neuropathy. The trans- The pathogenetic mechanism of distal axonal accumula- port rate of NF and of two other polypeptides ofMr 64,000 and tion of NF is unknown. Two main hypotheses have been put 62,000 were selectively increased. Other components of the forward, both assuming that NF are transported at decreas- slow axonal transport were not affected. Acceleration of la- ing rates and are eventually blocked (14, 15). However, slow beled NF was also observed when 2,5-hexanedione was given axonal transport has not been studied. -
Pili Torti: a Feature of Numerous Congenital and Acquired Conditions
Journal of Clinical Medicine Review Pili Torti: A Feature of Numerous Congenital and Acquired Conditions Aleksandra Hoffmann 1 , Anna Wa´skiel-Burnat 1,*, Jakub Z˙ ółkiewicz 1 , Leszek Blicharz 1, Adriana Rakowska 1, Mohamad Goldust 2 , Małgorzata Olszewska 1 and Lidia Rudnicka 1 1 Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; [email protected] (A.H.); [email protected] (J.Z.);˙ [email protected] (L.B.); [email protected] (A.R.); [email protected] (M.O.); [email protected] (L.R.) 2 Department of Dermatology, University Medical Center of the Johannes Gutenberg University, 55122 Mainz, Germany; [email protected] * Correspondence: [email protected]; Tel.: +48-22-5021-324; Fax: +48-22-824-2200 Abstract: Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180◦ along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting Citation: Hoffmann, A.; cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such Wa´skiel-Burnat,A.; Zółkiewicz,˙ J.; as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, Blicharz, L.; Rakowska, A.; Goldust, M.; Olszewska, M.; Rudnicka, L. -
Jan-March 2015
NEUROLOGICAL RARE DISEASE 1-855-HELPCMT SPECIAL REPORT www.hnf-cure.org FEBRUARY 2015 TM SELECTED ARTICLES 6 I Rare Diseases Are Not So Rare in Neurology update 14 I Assessing the Burden CMT Winter 2015 of Illness in Narcolepsy 22 I Bright Spotty Lesions May Indicate Neuromyelitis Optica Spectrum Disorder 30 I Multiple System Atrophy Versus Parkinson’s Disease: Similarities and Differences The Hereditary Neuropathy48 I New Tool May Help Breaking News: First Therapeutic Gene Identify Cognitive Deficits in Huntington’s Disease A SUPPLEMENTFoundation’s TO NEUROLOGY REVIEWS mission is to increase Therapy to Treat an Inherited Neuropathy awareness and accurate diagnosis of Charcot-Marie-Tooth (CMT) is Approved for Clinical Trial! and related inherited neuropathies, support patients and families with The first disease community to receive a therapeutic gene to the spinal cord for critical information to improve an ultra rare inherited neuropathy is Giant Axonal Neuropathy (GAN). Congratulations quality of life, and fund research to Hannah’s Hope Fund (HHF), a 501(c)3 public charity, which has driven this that will lead to treatments and collaborative research in less than six years. Six million dollars has been raised to cures. date to fund pre-clinical and clinical research on this rare disease. The Phase 1 trial is recruiting - info here: Intrathecal Administration of scAAV9/ JeT-GAN for the Treatment of Giant Axonal Neuropathy patients. A benign viral Inside This Issue vector known as adeno associated virus serotype 9 (AAV9) is the “Fed-Ex truck” delivering a healthy copy of the GAN gene to the nerves in the spinal cord of affected patients.