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Raskovalova T, Deegan PB, Mistry PK, Pavlova E, Yang R, Zimran A, Berger J, Bourgne C, Pereira B, Labarère J, Berger MG. Accuracy of chitotriosidase activity and CCL18 concentration in assessing type I Gaucher disease severity. A systematic review with meta-analysis of individual participant data. Haematologica 2021; 106:437-445. [PMID: 32001533 PMCID: PMC7849573 DOI: 10.3324/haematol.2019.236083] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/20/2020] [Indexed: 12/22/2022] Open
Abstract
Chitotriosidase activity and CCL18 concentration are interchangeably used for monitoring Gaucher disease (GD) activity, together with clinical assessment. However, comparative studies of these two biomarkers are scarce and of limited sample size. The aim of this systematic review with meta-analysis of individual participant data (IPD) was to compare the accuracy of chitotriosidase activity and CCL18 concentration for assessing type I GD severity. We identified cross-sectional and prospective cohort studies by searching Medline, EMBASE, and CENTRAL from 1995 to June 2017, and by contacting research groups. The primary outcome was a composite of liver volume >1.25 multiple of normal (MN), spleen volume >5 MN, hemoglobin concentration <11 g/dL, and platelet count <100x109/L. Overall, IPD included 1109 observations from 334 patients enrolled in nine primary studies, after excluding 111 patients with undocumented values and 18 patients with deficient chitotriosidase activity. IPD were unavailable for 14 eligible primary studies. The primary outcome was associated with a 5.3-fold (95% confidence interval [CI], 4.2 to 6.6) and 3.0-fold (95% CI, 2.6 to 3.6) increase of the geometric mean for chitotriosidase activity and CCL18 concentration, respectively. The corresponding areas under the receiver operating characteristics curves were 0.82 and 0.84 (summary difference, 0.02, 95% CI, -0.02 to 0.05). The addition of chitotriosidase activity did not improve the accuracy of CCL18 concentration. Estimates remained robust in the sensitivity analysis and consistent across subgroups. Neither chitotriosidase activity nor CCL18 concentration varied significantly according to a recent history of bone events among 97 patients. In conclusion, CCL18 concentration is as accurate as chitotriosidase activity in assessing hematological and visceral parameters of GD severity and can be measured in all GD patients. This meta-analysis supports the use of CCL18 rather than chitotriosidase activity for monitoring GD activity in routine practice.
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Affiliation(s)
- Tatiana Raskovalova
- Lab immunologie, Grenoble University Hospital, Universite' Grenoble Alpes, Grenoble, France
| | - Patrick B Deegan
- Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Pramod K Mistry
- Pediatric Gastroenterology and Hepatology, Yale University School of Medicine, New Haven, CT, USA
| | - Elena Pavlova
- Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Ruby Yang
- Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Ari Zimran
- Shaare Zedek Medical Center, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Juliette Berger
- CHU Clermont-Ferrand, Hopital Estaing, Hematologie Biologique, Clermont-Ferrand, France
| | - Céline Bourgne
- CHU Clermont-Ferrand, Hopital Estaing, Hematologie Biologique, Clermont-Ferrand, France
| | - Bruno Pereira
- DRCI, CHU Clermont-Ferrand, Clermont-Ferrand Cedex, France
| | - José Labarère
- Univ. Grenoble Alpes, TIMC UMR CNRS 5525, Grenoble University Hospital, Grenoble, France
| | - Marc G Berger
- CHU Clermont-Ferrand, Hopital Estaing, Hematologie Biologique, Clermont-Ferrand, France
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2
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Novel biomarkers for lysosomal storage disorders: Metabolomic and proteomic approaches. Clin Chim Acta 2020; 509:195-209. [PMID: 32561345 DOI: 10.1016/j.cca.2020.06.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022]
Abstract
Lysosomal storage disorders (LSDs) are characterized by the accumulation of specific disease substrates inside the lysosomes of various cells, eventually leading to the deterioration of cellular function and multisystem organ damage. With the continuous discovery and validation of novel and advanced therapies for most LSDs, there is an urgent need to discover more versatile and clinically relevant biomarkers. The utility of these biomarkers should ideally extend beyond the screening and diagnosis of LSDs to the evaluation of disease severity and monitoring of therapy. Metabolomic and proteomic approaches provide the means to the discovery and validation of such novel biomarkers. This is achieved mainly through the application of various mass spectrometric techniques to common and easily accessible biological samples, such as plasma, urine and dried blood spots. In this review, we tried to summarize the complexity of the lysosomal disorders phenotypes, their current diagnostic and therapeutic approaches, the various techniques supporting metabolomic and proteomic studies and finally we tried to explore the newly discovered biomarkers for most LSDs and their reported clinical values.
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Kzhyshkowska J, Gratchev A, Goerdt S. Human Chitinases and Chitinase-Like Proteins as Indicators for Inflammation and Cancer. Biomark Insights 2017. [DOI: 10.1177/117727190700200023] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] 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
- Department of Dermatology and Allergology, University Medical Centre Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim D-68167, Germany
| | - Alexei Gratchev
- Department of Dermatology and Allergology, University Medical Centre Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim D-68167, Germany
| | - Sergij Goerdt
- Department of Dermatology and Allergology, University Medical Centre Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim D-68167, Germany
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4
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Kramer G, Wegdam W, Donker-Koopman W, Ottenhoff R, Gaspar P, Verhoek M, Nelson J, Gabriel T, Kallemeijn W, Boot RG, Laman JD, Vissers JPC, Cox T, Pavlova E, Moran MT, Aerts JM, van Eijk M. Elevation of glycoprotein nonmetastatic melanoma protein B in type 1 Gaucher disease patients and mouse models. FEBS Open Bio 2016; 6:902-13. [PMID: 27642553 PMCID: PMC5011488 DOI: 10.1002/2211-5463.12078] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/18/2016] [Accepted: 04/27/2016] [Indexed: 12/23/2022] Open
Abstract
Gaucher disease is caused by inherited deficiency of lysosomal glucocerebrosidase. Proteome analysis of laser‐dissected splenic Gaucher cells revealed increased amounts of glycoprotein nonmetastatic melanoma protein B (gpNMB). Plasma gpNMB was also elevated, correlating with chitotriosidase and CCL18, which are established markers for human Gaucher cells. In Gaucher mice, gpNMB is also produced by Gaucher cells. Correction of glucocerebrosidase deficiency in mice by gene transfer or pharmacological substrate reduction reverses gpNMB abnormalities. In conclusion, gpNMB acts as a marker for glucosylceramide‐laden macrophages in man and mouse and gpNMB should be considered as candidate biomarker for Gaucher disease in treatment monitoring.
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Affiliation(s)
- Gertjan Kramer
- Department of Medical Biochemistry Academic Medical Center Amsterdam The Netherlands; European Molecular Biology Laboratory Germany
| | - Wouter Wegdam
- Department of Gynecology Academic Medical Center Amsterdam The Netherlands
| | - Wilma Donker-Koopman
- Department of Medical Biochemistry Academic Medical Center Amsterdam The Netherlands
| | - Roelof Ottenhoff
- Department of Medical Biochemistry Academic Medical Center Amsterdam The Netherlands
| | - Paulo Gaspar
- Organelle Biogenesis & Function Group Instituto de Investigação e Inovação em Saúde (I3S) Porto Portugal; Institute of Molecular and Cell Biology (IBMC) Universidade do Porto Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS) Universidade do Porto Portugal
| | - Marri Verhoek
- Department of Medical Biochemistry Leiden Institute of Chemistry Leiden University The Netherlands
| | - Jessica Nelson
- Department of Medical Biochemistry Academic Medical Center Amsterdam The Netherlands
| | - Tanit Gabriel
- Department of Medical Biochemistry Academic Medical Center Amsterdam The Netherlands
| | - Wouter Kallemeijn
- Department of Medical Biochemistry Leiden Institute of Chemistry Leiden University The Netherlands
| | - Rolf G Boot
- Department of Medical Biochemistry Leiden Institute of Chemistry Leiden University The Netherlands
| | - Jon D Laman
- Department of Neuroscience University Medical Center Groningen The Netherlands
| | | | - Timothy Cox
- Department of Internal Medicine Addenbrooke's Hospital Cambridge UK
| | - Elena Pavlova
- Department of Internal Medicine Addenbrooke's Hospital Cambridge UK
| | | | - Johannes M Aerts
- Department of Medical Biochemistry Leiden Institute of Chemistry Leiden University The Netherlands
| | - Marco van Eijk
- Department of Medical Biochemistry Academic Medical Center Amsterdam The Netherlands; Department of Medical Biochemistry Leiden Institute of Chemistry Leiden University The Netherlands
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5
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Ferraz MJ, Marques ARA, Appelman MD, Verhoek M, Strijland A, Mirzaian M, Scheij S, Ouairy CM, Lahav D, Wisse P, Overkleeft HS, Boot RG, Aerts JM. Lysosomal glycosphingolipid catabolism by acid ceramidase: formation of glycosphingoid bases during deficiency of glycosidases. FEBS Lett 2016; 590:716-25. [PMID: 26898341 DOI: 10.1002/1873-3468.12104] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 12/19/2022]
Abstract
Glycosphingoid bases are elevated in inherited lysosomal storage disorders with deficient activity of glycosphingolipid catabolizing glycosidases. We investigated the molecular basis of the formation of glucosylsphingosine and globotriaosylsphingosine during deficiency of glucocerebrosidase (Gaucher disease) and α-galactosidase A (Fabry disease). Independent genetic and pharmacological evidence is presented pointing to an active role of acid ceramidase in both processes through deacylation of lysosomal glycosphingolipids. The potential pathophysiological relevance of elevated glycosphingoid bases generated through this alternative metabolism in patients suffering from lysosomal glycosidase defects is discussed.
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Affiliation(s)
- Maria J Ferraz
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - André R A Marques
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Monique D Appelman
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Marri Verhoek
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Anneke Strijland
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Mina Mirzaian
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Saskia Scheij
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Cécile M Ouairy
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Daniel Lahav
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Patrick Wisse
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Herman S Overkleeft
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Rolf G Boot
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Johannes M Aerts
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands.,Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
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6
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Marques ARA, Gabriel TL, Aten J, van Roomen CPAA, Ottenhoff R, Claessen N, Alfonso P, Irún P, Giraldo P, Aerts JMFG, van Eijk M. Gpnmb Is a Potential Marker for the Visceral Pathology in Niemann-Pick Type C Disease. PLoS One 2016; 11:e0147208. [PMID: 26771826 PMCID: PMC4714856 DOI: 10.1371/journal.pone.0147208] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/30/2015] [Indexed: 11/18/2022] Open
Abstract
Impaired function of NPC1 or NPC2 lysosomal proteins leads to the intracellular accumulation of unesterified cholesterol, the primary defect underlying Niemann-Pick type C (NPC) disease. In addition, glycosphingolipids (GSLs) accumulate in lysosomes as well. Intralysosomal lipid accumulation triggers the activation of a set of genes, including potential biomarkers. Transcript levels of Gpnmb have been shown to be elevated in various tissues of an NPC mouse model. We speculated that Gpnmb could serve as a marker for visceral lipid accumulation in NPC disease. We report that Gpnmb expression is increased at protein level in macrophages in the viscera of Npc1nih/nih mice. Interestingly, soluble Gpnmb was also found to be increased in murine and NPC patient plasma. Exposure of RAW264.7 macrophages to the NPC-phenotype-inducing drug U18666A also upregulated Gpnmb expression. Inhibition of GSL synthesis with the glucosylceramide synthase (GCS) inhibitor N-butyl-1-deoxynojirimycin prevented U18666A-induced Gpnmb induction and secretion. In summary, we show that Gpnmb is upregulated in NPC mice and patients, most likely due to GSL accumulation.
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Affiliation(s)
- André R. A. Marques
- Department of Medical Biochemistry, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Tanit L. Gabriel
- Department of Medical Biochemistry, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Jan Aten
- Department of Pathology, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | | | - Roelof Ottenhoff
- Department of Medical Biochemistry, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Nike Claessen
- Department of Pathology, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Pilar Alfonso
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Unidad de Investigación Traslacional, Zaragoza, Spain
| | - Pilar Irún
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Unidad de Investigación Traslacional, Zaragoza, Spain
| | - Pilar Giraldo
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Unidad de Investigación Traslacional, Zaragoza, Spain
| | - Johannes M. F. G. Aerts
- Department of Medical Biochemistry, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
- Department of Biochemistry, Leiden Institute of Chemistry, Leiden University, 2300 RA, Leiden, The Netherlands
| | - Marco van Eijk
- Department of Medical Biochemistry, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands
- Department of Biochemistry, Leiden Institute of Chemistry, Leiden University, 2300 RA, Leiden, The Netherlands
- * E-mail:
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7
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Chiarla C, Giovannini I, Antuzzi D, Piras A, Ardito F, Giuliante F. Clinical use of plasma chitotriosidase in severe sepsis. Curr Med Res Opin 2016; 32:273-6. [PMID: 26550788 DOI: 10.1185/03007995.2015.1118370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Plasma chitotriosidase activity (ChT) was previously proposed to quantify severity of sepsis. In a complex surgical case, with prolonged sepsis and consistently high ChT, we found that the least increased values occurred in stages of extreme illness, with profound hypocholesterolemia. ChT needs better characterization before becoming a reliable biomarker of septic evolution.
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Affiliation(s)
- Carlo Chiarla
- a a CNR-IASI Center for the Pathophysiology of Shock, Catholic University of the Sacred Heart, Agostino Gemelli Hospital , Rome , Italy
| | - Ivo Giovannini
- a a CNR-IASI Center for the Pathophysiology of Shock, Catholic University of the Sacred Heart, Agostino Gemelli Hospital , Rome , Italy
| | - Daniela Antuzzi
- b b Institute of Pediatrics, Catholic University of the Sacred Heart, Agostino Gemelli Hospital , Rome , Italy
| | - Andrea Piras
- b b Institute of Pediatrics, Catholic University of the Sacred Heart, Agostino Gemelli Hospital , Rome , Italy
| | - Francesco Ardito
- c c Hepatobiliary Surgery Unit (Dept of Surgical Sciences), Catholic University of the Sacred Heart, Agostino Gemelli Hospital , Rome , Italy
| | - Felice Giuliante
- c c Hepatobiliary Surgery Unit (Dept of Surgical Sciences), Catholic University of the Sacred Heart, Agostino Gemelli Hospital , Rome , Italy
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8
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Wasserstein MP, Jones SA, Soran H, Diaz GA, Lippa N, Thurberg BL, Culm-Merdek K, Shamiyeh E, Inguilizian H, Cox GF, Puga AC. Successful within-patient dose escalation of olipudase alfa in acid sphingomyelinase deficiency. Mol Genet Metab 2015; 116:88-97. [PMID: 26049896 PMCID: PMC4561589 DOI: 10.1016/j.ymgme.2015.05.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/27/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Olipudase alfa, a recombinant human acid sphingomyelinase (rhASM), is an investigational enzyme replacement therapy (ERT) for patients with ASM deficiency [ASMD; Niemann-Pick Disease (NPD) A and B]. This open-label phase 1b study assessed the safety and tolerability of olipudase alfa using within-patient dose escalation to gradually debulk accumulated sphingomyelin and mitigate the rapid production of metabolites, which can be toxic. Secondary objectives were pharmacokinetics, pharmacodynamics, and exploratory efficacy. METHODS Five adults with nonneuronopathic ASMD (NPD B) received escalating doses (0.1 to 3.0 mg/kg) of olipudase alfa intravenously every 2 weeks for 26 weeks. RESULTS All patients successfully reached 3.0mg/kg without serious or severe adverse events. One patient repeated a dose (2.0 mg/kg) and another had a temporary dose reduction (1.0 to 0.6 mg/kg). Most adverse events (97%) were mild and all resolved without sequelae. The most common adverse events were headache, arthralgia, nausea and abdominal pain. Two patients experienced single acute phase reactions. No patient developed hypersensitivity or anti-olipudase alfa antibodies. The mean circulating half-life of olipudase alfa ranged from 20.9 to 23.4h across doses without accumulation. Ceramide, a sphingomyelin catabolite, rose transiently in plasma after each dose, but decreased over time. Reductions in sphingomyelin storage, spleen and liver volumes, and serum chitotriosidase activity, as well as improvements in infiltrative lung disease, lipid profiles, platelet counts, and quality of life assessments, were observed. CONCLUSIONS This study provides proof-of-concept for the safety and efficacy of within-patient dose escalation of olipudase alfa in patients with nonneuronopathic ASMD.
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Affiliation(s)
- Melissa P Wasserstein
- Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simon A Jones
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, CMFT, University of Manchester, Manchester, UK
| | - Handrean Soran
- Cardiovascular Trials Unit, Central Manchester University Hospital, Manchester, UK
| | - George A Diaz
- Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natalie Lippa
- Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Kerry Culm-Merdek
- Clinical and Experimental Pharmacology, Sanofi, Bridgewater, NJ, USA
| | - Elias Shamiyeh
- Clinical and Experimental Pharmacology, Sanofi, Bridgewater, NJ, USA
| | | | - Gerald F Cox
- Clinical Development, Genzyme, a Sanofi company, Cambridge, MA, USA
| | - Ana Cristina Puga
- Clinical Development, Genzyme, a Sanofi company, Cambridge, MA, USA.
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9
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Bennett LL, Turcotte K. Eliglustat tartrate for the treatment of adults with type 1 Gaucher disease. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:4639-47. [PMID: 26345314 PMCID: PMC4554398 DOI: 10.2147/dddt.s77760] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this article is to review eliglustat tartrate, a substrate reduction therapy, for the treatment of Gaucher disease type 1 (GD1). GD is an rare inborn error of metabolism caused by accumulation of lipid substrates such as glucosylceramide within the monocyte-macrophage system that affects the body by causing enlargement of the spleen and liver, destruction of bone, and abnormalities of the lungs and blood, such as anemia, thrombocytopenia, and leukopenia. GD is classified into three types: GD1, a chronic and non-neuronopathic disease accounting for 95% of GD cases; and types 2 and 3 (GD2 GD3) which are more progressive diseases with no approved drugs available at this time. Treatment options for GD1 include enzyme replacement therapy and substrate reduction therapy. Eliglustat works by inhibiting UDP-glucosylceramide synthase, the first enzyme that catalyzes the biosynthesis of glycosphingolipids, thus reducing the load of glucosylceramide influx into the lysosome. Eliglustat was approved by the US Food and Drug Administration after three Phase I, two Phase II, and two Phase III clinical trials. The dose of eliglustat is 84 mg twice a day or once daily depending on the cytochrome P450 2D6 genotype of the patient.
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10
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Byeon SK, Lee JY, Lee JS, Moon MH. Lipidomic profiling of plasma and urine from patients with Gaucher disease during enzyme replacement therapy by nanoflow liquid chromatography-tandem mass spectrometry. J Chromatogr A 2015; 1381:132-9. [PMID: 25597892 DOI: 10.1016/j.chroma.2015.01.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/18/2014] [Accepted: 01/04/2015] [Indexed: 10/24/2022]
Abstract
Gaucher disease (GD) is a rare genetic disorder that arises from lipid species, especially monohexosylceramide (MHC), accumulating in different organs. GD results from a β-glucocerebrosidase deficiency, causing metabolic or neurologic complications. This study comprehensively profiled lipids from patients and healthy controls to discover active lipid species related to GD. Most studies have evaluated lipids from one type of biological sample, such as plasma, urine, or spinal fluid, which are the main sources of lipids in human bodies. The purpose of this study, however, was to collect and assess both plasma and urine samples from a group of individuals, explore the lipids, and select characteristic species that show significant differences between controls and patients from the two sources. Also, the response of lipids to enzyme replacement therapy (ERT), which is targeted to reduce excessive lipid accumulation within lysosomes, was investigated by obtaining plasma and urine from patients after receiving the therapy. Most lipid species were found in both plasma and urine but their concentrations differed, and some species were found in either plasma or urine only. Out of 125 plasma and 105 urinary lipids that were identified by nLC-ESI-MS/MS, 20 plasma and 10 urinary lipids were selected as characteristic species for having average concentrations that were significantly increased or decreased in patients by greater than 2-fold. Moreover, the concentrations of most lipids that showed greater than 2-fold of difference in patients decreased after ERT indicating that these species were directly or indirectly affected by the therapy.
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Affiliation(s)
- Seul Kee Byeon
- Department of Chemistry, Yonsei University, Seoul 120-749, South Korea
| | - Ju Yong Lee
- Department of Chemistry, Yonsei University, Seoul 120-749, South Korea
| | - Jin-Sung Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 120-752, South Korea.
| | - Myeong Hee Moon
- Department of Chemistry, Yonsei University, Seoul 120-749, South Korea.
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11
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Abstract
OBJECTIVE To review the epidemiology, pathophysiology, and treatments of Gaucher disease (GD), focusing on the role of enzyme replacement therapy (ERT), andsubstrate reduction therapy (SRT). DATA SOURCES A literature search through PubMed (1984-May 2013) of English language articles was performed with terms: Gaucher's disease, lysosomal storage disease. Secondary and tertiary references were obtained by reviewing related articles. STUDY SELECTION AND DATA EXTRACTION All articles in English identified from the data sources, clinical studies using ERT, SRT and articles containing other interesting aspects were included. DATA SYNTHESIS GD is the most common inherited LSD, characterized by a deficiency in the activity of the enzyme acid β-glucosidase, which leads to accumulation of glucocerebroside within lysosomes of macrophages, leading to hepatosplenomegaly, bone marrow suppression, and bone lesions. GD is classified into 3 types: type 1 GD (GD1) is chronic and non-neuronopathic, accounting for 95% of GDs, and types 2 and 3 (GD2, GD3) cause nerve cell destruction. Regular monitoring of enzyme chitotriosidase and pulmonary and activation-regulated chemokines are useful to confirm the diagnosis and effectiveness of GD treatment. CONCLUSIONS There are 4 treatments available for GD1: 3 ERTs and 1 SRT. Miglustat, an SRT, is approved for mild to moderate GD1. ERTs are available for moderate to severe GD1 and can improve quality of life within the first year of treatment. The newest ERT, taliglucerase alfa, is plant-cell derived that can be produced on a large scale at lower cost. Eliglustat tartrate, another SRT, is under phase 3 clinical trials. No drugs have been approved for GD2 or GD3.
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12
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Boot RG, van Breemen MJ, Wegdam W, Sprenger RR, de Jong S, Speijer D, Hollak CEM, Van Dussen L, Hoefsloot HCJ, Smilde AK, De Koster CG, Vissers JPC, Aerts JMFG. Gaucher disease: a model disorder for biomarker discovery. Expert Rev Proteomics 2014; 6:411-9. [DOI: 10.1586/epr.09.54] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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Goker-Alpan O. Therapeutic approaches to bone pathology in Gaucher disease: past, present and future. Mol Genet Metab 2011; 104:438-47. [PMID: 21889384 DOI: 10.1016/j.ymgme.2011.08.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 08/05/2011] [Accepted: 08/05/2011] [Indexed: 12/20/2022]
Abstract
Enzyme replacement therapy (ERT) is effective for the treatment of the systemic manifestations of Gaucher disease (GD) and can have a significant impact on skeletal manifestations. Bone involvement is broad and can occur in otherwise clinically asymptomatic individuals. The heterogeneity in GD-related bone disease may implicate multiple pathological processes such as disruption of coordinated bone cell activity, in addition to the physical impact of Gaucher cells causing vascular occlusion. Accumulated data suggests that earlier treatment initiation decreases skeletal complications and that bone disease may require a longer duration of treatment and higher dose than is necessary for organ involvement and hematopoietic manifestations. However, in some patients, bone manifestations persist and even worsen despite ERT, regardless of dose or duration of treatment. Treating skeletal disease should be considered of equal importance as treating visceral and hematologic manifestations. When treatment decisions involve multiple enzyme preparations and other therapeutic modalities such small molecules, the choice should be tailored on an individual basis with continuing evaluation.
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Affiliation(s)
- Ozlem Goker-Alpan
- Lysosomal Disorders Research and Treatment Unit, Center for Clinical Trials, Springfield, VA 22152, USA.
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14
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Aerts JMFG, Kallemeijn WW, Wegdam W, Joao Ferraz M, van Breemen MJ, Dekker N, Kramer G, Poorthuis BJ, Groener JEM, Cox-Brinkman J, Rombach SM, Hollak CEM, Linthorst GE, Witte MD, Gold H, van der Marel GA, Overkleeft HS, Boot RG. Biomarkers in the diagnosis of lysosomal storage disorders: proteins, lipids, and inhibodies. J Inherit Metab Dis 2011; 34:605-19. [PMID: 21445610 PMCID: PMC3109260 DOI: 10.1007/s10545-011-9308-6] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 01/21/2011] [Accepted: 02/17/2011] [Indexed: 12/23/2022]
Abstract
A biomarker is an analyte indicating the presence of a biological process linked to the clinical manifestations and outcome of a particular disease. In the case of lysosomal storage disorders (LSDs), primary and secondary accumulating metabolites or proteins specifically secreted by storage cells are good candidates for biomarkers. Clinical applications of biomarkers are found in improved diagnosis, monitoring disease progression, and assessing therapeutic correction. These are illustrated by reviewing the discovery and use of biomarkers for Gaucher disease and Fabry disease. In addition, recently developed chemical tools allowing specific visualization of enzymatically active lysosomal glucocerebrosidase are described. Such probes, coined inhibodies, offer entirely new possibilities for more sophisticated molecular diagnosis, enzyme replacement therapy monitoring, and fundamental research.
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Affiliation(s)
- Johannes M F G Aerts
- Sphinx-Amsterdam Lysosome Center, Departments of Medical Biochemistry and Internal Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
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15
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Bueter M, Dubb SS, Gill A, Joannou L, Ahmed A, Frankel AH, Tam FWK, le Roux CW. Renal cytokines improve early after bariatric surgery. Br J Surg 2010; 97:1838-44. [DOI: 10.1002/bjs.7264] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2010] [Indexed: 01/18/2023]
Abstract
Abstract
Background
Bariatric surgery has been suggested to improve arterial hypertension and renal function. This prospective controlled observational study aimed to investigate changes in renal inflammation, renal function and arterial blood pressure before and after bariatric surgery.
Methods
Blood pressure was measured, and urine and blood samples were collected from 34 morbidly obese patients before and 4 weeks after bariatric surgery. Serum levels of cystatin C, creatinine, albumin, cholesterol and C-reactive protein (CRP) were measured, along with urinary cytokine/creatinine ratios for macrophage migration inhibitory factor (MIF), monocyte chemotactic protein (MCP) 1, chemokine ligand (CCL) 18 and CCL-15.
Results
Mean(s.e.m.) bodyweight dropped from 124·1(2·6) to 114·8(2·4) kg (P < 0·001) and mean arterial blood pressure decreased from 105·7(1·8) to 95·5(1·2) mmHg (P < 0·001) in 4 weeks. Systemic and urinary inflammatory markers improved, with a reduction in serum CRP level (P < 0·001), and decreased urinary MIF/creatinine (P < 0·001), MCP-1/creatinine (P < 0·001) and CCL-18/creatinine (P = 0·003) ratios. In contrast, urinary CCL-15/creatinine ratios did not change and the glomerular filtration rate, measured by serum cystatin C, was unchanged (P = 0·615).
Conclusion
Surgically induced weight loss contributed to a decrease in blood pressure and markers of renal inflammation. The reduced levels of CRP and urinary cytokines suggest that bariatric surgery attenuates systemic and renal inflammatory status.
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Affiliation(s)
- M Bueter
- Imperial Weight Centre, Department of Investigative Medicine, Imperial College London, London, UK
- Department of Surgery, University of Würzburg, Würzburg, Germany
| | - S S Dubb
- Imperial Weight Centre, Department of Investigative Medicine, Imperial College London, London, UK
| | - A Gill
- Imperial Weight Centre, Department of Investigative Medicine, Imperial College London, London, UK
| | - L Joannou
- Chemical Pathology, St Mary's Hospital, Imperial College London, London, UK
| | - A Ahmed
- Imperial Weight Centre, Department of Academic Surgery, Imperial College London, London, UK
| | - A H Frankel
- Imperial Kidney and Transplant Institute, Hammersmith Hospital, Imperial College London, London, UK
| | - F W K Tam
- Imperial Kidney and Transplant Institute, Hammersmith Hospital, Imperial College London, London, UK
| | - C W le Roux
- Imperial Weight Centre, Department of Investigative Medicine, Imperial College London, London, UK
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16
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Bodamer OA, Hung C. Laboratory and genetic evaluation of Gaucher disease. Wien Med Wochenschr 2010; 160:600-4. [DOI: 10.1007/s10354-010-0814-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 06/16/2010] [Indexed: 01/25/2023]
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17
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Abstract
Gaucher disease (GD), the inherited deficiency of the lysosomal enzyme glucocerebrosidase, presents with a wide range of symptoms of varying severity, and primarily affects the skeletal, hematologic and nervous systems. To date, the standard of care has included enzyme replacement therapy with imiglucerase. Although imiglucerase is highly effective in reversing the visceral and hematologic manifestations, skeletal disease is slow to respond, pulmonary involvement is relatively resistant, and the CNS involvement is not impacted. Because of the recent manufacturing and processing problems, the research and development of alternative therapeutics has become more pressing. The divergent phenotypes and the heterogeneity involving different organ systems implicates the involvement of several pathological processes that include enzyme deficiency, substrate accumulation, protein misfolding, and macrophage activation, that differ in each patient with GD. Thus, the therapy should be tailored individually in order to target multiple pathways that interplay in GD.
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Affiliation(s)
- Ozlem Goker-Alpan
- Lysosomal Diseases Research and Treatment Unit, Center for Clinical Trials, O&O Alpan LLC, Springfield, VA, USA
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18
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Cajaiba MM, Reyes-Múgica M. Gaucher or pseudo-Gaucher? The challenge of several diseases colliding in a pediatric patient. Hum Pathol 2009; 40:594-8. [DOI: 10.1016/j.humpath.2008.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Revised: 08/25/2008] [Accepted: 09/04/2008] [Indexed: 10/21/2022]
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19
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van Breemen MJ, Aerts JMFG, Sprenger RR, Speijer D. Potential artefacts in proteome analysis of plasma of Gaucher patients due to protease abnormalities. Clin Chim Acta 2008; 396:26-32. [PMID: 18640107 DOI: 10.1016/j.cca.2008.06.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Accepted: 06/17/2008] [Indexed: 11/26/2022]
Abstract
The plasma proteome of type I Gaucher disease patients was investigated by 2D gel electrophoresis (2DGE). Using the classical procedure with 8 M urea treated plasma, several high molecular weight proteins were absent from Gaucher plasma specimens, while additional low molecular weight proteins were visible. The latter were identified as proteolytic degradation products. Adding small amounts of patient plasma to control plasma gave extensive protein breakdown. The presence of 2.2 M thiourea/7.7 M urea in the rehydration solution totally prevented breakdown. In the 'urea only' solution, protease(s) uniquely present in Gaucher plasma, appear to be still active towards other denatured plasma proteins at low pH. Therapy of patients results in gradual disappearance of proteolytic capacity from plasma specimens, indicating it to be related to the presence of Gaucher storage cells. The proteolytic activity could be partly removed from Gaucher plasma samples by Concanavalin A, suggesting that glycoproteins are involved. Reduction of proteolysis by Pepstatin A and Leupeptin implies that cathepsins, proteases known to be overproduced by Gaucher storage cells, are involved. In conclusion, 2DGE Gaucher plasma proteomes should be interpreted cautiously given the abnormal high levels of proteases associated with this disorder.
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Affiliation(s)
- Mariëlle J van Breemen
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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20
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Cox TM, Aerts JMFG, Belmatoug N, Cappellini MD, vom Dahl S, Goldblatt J, Grabowski GA, Hollak CEM, Hwu P, Maas M, Martins AM, Mistry PK, Pastores GM, Tylki-Szymanska A, Yee J, Weinreb N. Management of non-neuronopathic Gaucher disease with special reference to pregnancy, splenectomy, bisphosphonate therapy, use of biomarkers and bone disease monitoring. J Inherit Metab Dis 2008; 31:319-36. [PMID: 18509745 DOI: 10.1007/s10545-008-0779-z] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 01/28/2008] [Accepted: 02/19/2008] [Indexed: 12/21/2022]
Abstract
Enzyme replacement was introduced as treatment for non-neuronopathic Gaucher disease more than 15 years ago. To ensure the best use of this costly ultra-orphan agent, a systematic disease management approach has been proposed by an international panel; this includes the development, by consensus, of achievable treatment goals. Here we critically review these goals and monitoring guidelines and incorporate emerging experience of the disease in the therapeutic era, as well as contemporary clinical research. This review makes recommendations related specifically to the management of pregnancy; the appropriate use of splenectomy and bisphosphonate treatment; the relevance of biochemical markers to disease monitoring; and the use of semi-quantitative methods for assessing bone marrow infiltration. In addition, we identify key areas for development, including the requirement for a validated index of disease severity; the need to correlate widely used biomarkers with long-term disease outcomes, and the desirability of establishing agreed standards for monitoring of bone disease particularly in infants and children with Gaucher disease.
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Affiliation(s)
- T M Cox
- Department of Medicine, University of Cambridge, Addenbrooke's NHS Foundation Hospitals Trust, Cambridge, UK.
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21
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Aerts JM, van Breemen MJ, Bussink AP, Ghauharali K, Sprenger R, Boot RG, Groener JE, Hollak CE, Maas M, Smit S, Hoefsloot HC, Smilde AK, Vissers JP, de Jong S, Speijer D, de Koster CG. Biomarkers for lysosomal storage disorders: identification and application as exemplified by chitotriosidase in Gaucher disease. Acta Paediatr 2008; 97:7-14. [PMID: 18339181 DOI: 10.1111/j.1651-2227.2007.00641.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
UNLABELLED A biomarker is an analyte that indicates the presence of a biological process linked to the clinical manifestations and outcome of a particular disease. An ideal biomarker provides indirect but ongoing determinations of disease activity. In the case of lysosomal storage disorders (LSDs), metabolites or proteins specifically secreted by storage cells are good candidates for biomarkers. Potential clinical applications of biomarkers are found in improved diagnosis, monitoring of disease progression and assessment of therapeutic correction. These applications are illustrated by reviewing the use of plasma chitotriosidase in the clinical management of patients with Gaucher disease, the most common LSD. The ongoing debate on the value of biomarkers in patient management is addressed. Novel analytical methods have revolutionized the identification and measurement of biomarkers at the protein and metabolite level. Recent developments in biomarker discovery by proteomics are described and the future for biomarkers of LSDs is discussed. CONCLUSION Besides direct applications for biomarkers in patient management, biomarker searches are likely to render new insights into pathophysiological mechanisms and metabolic adaptations, and may provide new targets for therapeutic intervention.
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Affiliation(s)
- Johannes M Aerts
- Clinical Proteomics Facility, Academic Medical Center, Amsterdam, The Netherlands.
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Maire I, Guffon N, Froissart R. [Current development and usefulness of biomarkers for Gaucher disease follow up]. Rev Med Interne 2008; 28 Suppl 2:S187-92. [PMID: 18228687 DOI: 10.1016/s0248-8663(07)78880-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Gaucher's disease is due to glucocerebrosidase deficiency which is responsible for the accumulation of non degraded glucosylceramide within the lysosomes of macrophages: these "Gaucher cells", overloaded and alternatively activated, release in patient's plasma numerous compounds (cytokines, chemokines, hydrolases...) some of which contribute to the various tissue damages. Some of these compounds are surrogate biomarkers which contribute to the evaluation of disease severity, progression and stabilisation or regression during treatment. To date, the most interesting biomarkers are chitotriosidase and the chemokine CCL18/PARC, especially in chitotriosidase deficient patients. These biomarkers together with the clinical evaluation help to therapeutic choice (treatment by enzyme replacement therapy or substrate reduction therapy) and initiation decision, response follow-up and dose adjustments. Biomarkers should be assessed every 12 months together with clinical evaluation in patients not receiving specific treatments. An assessment every 3 months is recommended during the first year of treatment. Then when clinical goals have been achieved, the frequency can be reduced to every 12 months if the therapeutic scheme is not modified.
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Affiliation(s)
- I Maire
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hospices Civils de Lyon, France.
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23
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Bargagli E, Maggiorelli C, Rottoli P. Human Chitotriosidase: A Potential New Marker of Sarcoidosis Severity. Respiration 2008; 76:234-8. [DOI: 10.1159/000134009] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 02/07/2008] [Indexed: 11/19/2022] Open
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24
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van Breemen MJ, de Fost M, Voerman JSA, Laman JD, Boot RG, Maas M, Hollak CEM, Aerts JM, Rezaee F. Increased plasma macrophage inflammatory protein (MIP)-1α and MIP-1β levels in type 1 Gaucher disease. Biochim Biophys Acta Mol Basis Dis 2007; 1772:788-96. [PMID: 17499484 DOI: 10.1016/j.bbadis.2007.04.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 04/03/2007] [Accepted: 04/03/2007] [Indexed: 11/25/2022]
Abstract
Pancytopenia, hepatosplenomegaly and skeletal complications are hallmarks of Gaucher disease. Monitoring of the outcome of therapy on skeletal status of Gaucher patients is problematic since currently available imaging techniques are expensive and not widely accessible. The availability of a blood test that relates to skeletal manifestations would be very valuable. We here report that macrophage inflammatory protein (MIP)-1alpha and MIP-1beta, both implicated in skeletal complications in multiple myeloma (MM), are significantly elevated in plasma of Gaucher patients. Plasma MIP-1alpha of patients (median 78 pg/ml, range 21-550 pg/ml, n=48) is elevated (normal median 9 pg/ml, range 0-208 pg/ml, n=39). Plasma MIP-1beta of patients (median 201 pg/ml, range 59-647 pg/ml, n=49) is even more pronouncedly increased (normal median 17 pg/ml, range 1-41 pg/ml, n=39; one outlier: 122 pg/ml). The increase in plasma MIP-1beta levels of Gaucher patients is associated with skeletal disease. The plasma levels of both chemokines decrease upon effective therapy. Lack of reduction of plasma MIP-1beta below 85 pg/ml during 5 years of therapy was observed in patients with ongoing skeletal disease. In conclusion, MIP-1alpha and MIP-1beta are elevated in plasma of Gaucher patients and remaining high levels of MIP-1beta during therapy seem associated with ongoing skeletal disease.
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Affiliation(s)
- Mariëlle J van Breemen
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105AZ, Amsterdam, The Netherlands
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