1
|
Hwang N, Kim SM, Kim YG, Ha C, Lee J, Choi BO, Sung WJ, Kim SH, Kim YM, Lee YW, Kim J, Kim JW, Jang JH, Lee J, Park HD. Clinical feature, GALC variant spectrum, and genotype-phenotype correlation in Korean Krabbe disease patients: Multicenter experience over 13 years. Clin Genet 2024. [PMID: 38515343 DOI: 10.1111/cge.14523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/14/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
Krabbe disease (KD) is an autosomal recessive neurodegenerative disorder caused by deficiency of the galactocerebrosidase (GALC) due to variants in the GALC gene. Here, we provide the first and the largest comprehensive analysis of clinical and genetic characteristics, and genotype-phenotype correlations of KD in Korean in comparison with other ethnic groups. From June 2010 to June 2023, 10 patients were diagnosed with KD through sequencing of GALC. Clinical features, and results of GALC sequencing, biochemical test, neuroimaging, and neurophysiologic test were obtained from medical records. An additional nine previously reported Korean KD patients were included for review. In Korean KD patients, the median age of onset was 2 years (3 months-34 years) and the most common phenotype was adult-onset (33%, 6/18) KD, followed by infantile KD (28%, 5/18). The most frequent variants were c.683_694delinsCTC (23%) and c.1901T>C (23%), while the 30-kb deletion was absent. Having two heterozygous pathogenic missense variants was associated with later-onset phenotype. Clinical features were similar to those of other ethnic groups. In Korean KD patients, the most common phenotype was the adult-onset type and the GALC variant spectrum was different from that of the Caucasian population. This study would further our understanding of KD.
Collapse
Affiliation(s)
- Narae Hwang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Mi Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young-Gon Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Changhee Ha
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung-Ok Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Jae Sung
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seung Hyun Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Young Mi Kim
- Department of Pediatrics, Pusan National University Hospital, Pusan, Republic of Korea
| | - Yong-Wha Lee
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Jieun Kim
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Jong-Won Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ja-Hyun Jang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| |
Collapse
|
2
|
Chan SH, Bylstra Y, Teo JX, Kuan JL, Bertin N, Gonzalez-Porta M, Hebrard M, Tirado-Magallanes R, Tan JHJ, Jeyakani J, Li Z, Chai JF, Chong YS, Davila S, Goh LL, Lee ES, Wong E, Wong TY, Prabhakar S, Liu J, Cheng CY, Eisenhaber B, Karnani N, Leong KP, Sim X, Yeo KK, Chambers JC, Tai ES, Tan P, Jamuar SS, Ngeow J, Lim WK, Gluckman PD, Goh DLM, Jain K, Kam S, Kassam I, Lakshmanan LN, Lee CG, Lee J, Lee SC, Lee YS, Li H, Lim CW, Lim TH, Loh M, Maurer-Stroh S, Mina TH, Mok SQ, Ng HK, Pua CJ, Riboli E, Rim TH, Sabanayagam C, Sim WC, Subramaniam T, Tan ES, Tan EK, Tantoso E, Tay D, Teo YY, Tham YC, Toh LXG, Tsai PK, van Dam RM, Veeravalli L, Khin-lin GW, Wilm A, Yang C, Yap F, Yew YW, Prabhakar S, Liu J, Cheng CY, Eisenhaber B, Karnani N, Leong KP, Sim X, Yeo KK, Chambers JC, Tai ES, Tan P, Jamuar SS, Ngeow J, Lim WK. Analysis of clinically relevant variants from ancestrally diverse Asian genomes. Nat Commun 2022; 13:6694. [PMID: 36335097 PMCID: PMC9637116 DOI: 10.1038/s41467-022-34116-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Asian populations are under-represented in human genomics research. Here, we characterize clinically significant genetic variation in 9051 genomes representing East Asian, South Asian, and severely under-represented Austronesian-speaking Southeast Asian ancestries. We observe disparate genetic risk burden attributable to ancestry-specific recurrent variants and identify individuals with variants specific to ancestries discordant to their self-reported ethnicity, mostly due to cryptic admixture. About 27% of severe recessive disorder genes with appreciable carrier frequencies in Asians are missed by carrier screening panels, and we estimate 0.5% Asian couples at-risk of having an affected child. Prevalence of medically-actionable variant carriers is 3.4% and a further 1.6% harbour variants with potential for pathogenic classification upon additional clinical/experimental evidence. We profile 23 pharmacogenes with high-confidence gene-drug associations and find 22.4% of Asians at-risk of Centers for Disease Control and Prevention Tier 1 genetic conditions concurrently harbour pharmacogenetic variants with actionable phenotypes, highlighting the benefits of pre-emptive pharmacogenomics. Our findings illuminate the diversity in genetic disease epidemiology and opportunities for precision medicine for a large, diverse Asian population.
Collapse
Affiliation(s)
- Sock Hoai Chan
- grid.410724.40000 0004 0620 9745Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, 169610 Singapore ,grid.428397.30000 0004 0385 0924Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857 Singapore ,grid.59025.3b0000 0001 2224 0361Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232 Singapore
| | - Yasmin Bylstra
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore
| | - Jing Xian Teo
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore
| | - Jyn Ling Kuan
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore
| | - Nicolas Bertin
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Mar Gonzalez-Porta
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Maxime Hebrard
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Roberto Tirado-Magallanes
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Joanna Hui Juan Tan
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Justin Jeyakani
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Zhihui Li
- grid.418377.e0000 0004 0620 715XGenome Research Informatics & Data Science Platform, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Jin Fang Chai
- grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549 Singapore
| | - Yap Seng Chong
- grid.4280.e0000 0001 2180 6431Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore ,grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Singapore, 117609 Singapore
| | - Sonia Davila
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore ,grid.428397.30000 0004 0385 0924Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, 169857 Singapore ,grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Genomic Medicine Centre, Singapore, 168582 Singapore
| | - Liuh Ling Goh
- grid.240988.f0000 0001 0298 8161Personalized Medicine Service, Tan Tock Seng Hospital, Singapore, 308433 Singapore
| | - Eng Sing Lee
- grid.59025.3b0000 0001 2224 0361Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232 Singapore ,grid.466910.c0000 0004 0451 6215National Healthcare Group Polyclinics, Singapore, 138543 Singapore
| | - Eleanor Wong
- grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Tien Yin Wong
- grid.419272.b0000 0000 9960 1711Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751 Singapore
| | | | - Shyam Prabhakar
- grid.418377.e0000 0004 0620 715XLaboratory of Systems Biology and Data Analytics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore
| | - Jianjun Liu
- grid.418377.e0000 0004 0620 715XHuman Genomics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore ,grid.4280.e0000 0001 2180 6431Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
| | - Ching-Yu Cheng
- grid.419272.b0000 0000 9960 1711Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751 Singapore ,grid.428397.30000 0004 0385 0924Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, 169857 Singapore
| | - Birgit Eisenhaber
- grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore ,grid.418325.90000 0000 9351 8132Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, 138671 Singapore
| | - Neerja Karnani
- grid.452264.30000 0004 0530 269XHuman Development, Singapore Institute for Clinical Sciences, Singapore, 117609 Singapore ,grid.418325.90000 0000 9351 8132Clinical Data Engagement, Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, 138671 Singapore ,grid.4280.e0000 0001 2180 6431Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117596 Singapore
| | - Khai Pang Leong
- grid.240988.f0000 0001 0298 8161Personalized Medicine Service, Tan Tock Seng Hospital, Singapore, 308433 Singapore ,grid.240988.f0000 0001 0298 8161Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, 308433 Singapore
| | - Xueling Sim
- grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549 Singapore
| | - Khung Keong Yeo
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore ,grid.419385.20000 0004 0620 9905Department of Cardiology, National Heart Centre Singapore, Singapore, 169609 Singapore ,grid.428397.30000 0004 0385 0924Duke-NUS Medical School, Singapore, 169857 Singapore
| | - John C. Chambers
- grid.59025.3b0000 0001 2224 0361Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232 Singapore ,Precision Health Research Singapore (PRECISE), Singapore, 139234 Singapore ,grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG UK
| | - E-Shyong Tai
- grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549 Singapore ,grid.4280.e0000 0001 2180 6431Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore ,grid.428397.30000 0004 0385 0924Duke-NUS Medical School, Singapore, 169857 Singapore ,Precision Health Research Singapore (PRECISE), Singapore, 139234 Singapore
| | - Patrick Tan
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore ,grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672 Singapore ,Precision Health Research Singapore (PRECISE), Singapore, 139234 Singapore ,grid.428397.30000 0004 0385 0924Cancer & Stem Cell Biology Program, Duke-NUS Medical School, Singapore, 169857 Singapore ,grid.4280.e0000 0001 2180 6431Cancer Science Institute of Singapore, National University of Singapore, Singapore, 117599 Singapore
| | - Saumya S. Jamuar
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore ,grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Genomic Medicine Centre, Singapore, 168582 Singapore ,grid.414963.d0000 0000 8958 3388Genetics Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, 229899 Singapore ,grid.428397.30000 0004 0385 0924Paediatric Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857 Singapore
| | - Joanne Ngeow
- grid.410724.40000 0004 0620 9745Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore, 169610 Singapore ,grid.428397.30000 0004 0385 0924Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857 Singapore ,grid.59025.3b0000 0001 2224 0361Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232 Singapore ,grid.185448.40000 0004 0637 0221Institute of Molecular and Cellular Biology, Agency for Science, Technology and Research, Singapore, 138673 Singapore
| | - Weng Khong Lim
- grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Institute of Precision Medicine, Singapore, 169609 Singapore ,grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Genomic Medicine Centre, Singapore, 168582 Singapore ,grid.428397.30000 0004 0385 0924Cancer & Stem Cell Biology Program, Duke-NUS Medical School, Singapore, 169857 Singapore
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Wang Y, Wang SY, Li K, Zhu YL, Xia K, Sun DD, Ai WL, Fu XM, Ye QR, Li J, Chen HZ. Adult-onset Krabbe disease presenting with progressive myoclonic epilepsy and asymmetric occipital lesions: A case report. Front Neurol 2022; 13:1010150. [PMID: 36341094 PMCID: PMC9633861 DOI: 10.3389/fneur.2022.1010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/30/2022] [Indexed: 11/20/2022] Open
Abstract
Krabbe disease (KD), also known as globoid cell leukodystrophy, is a rare autosomal recessive condition caused by mutations in the galactocerebrosidase (GALC) gene. KD is more common in infants and young children than in adults. We reported the case of an adult-onset KD presenting with progressive myoclonic epilepsy (PME) and cortical lesions mimicking mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome. The whole-exome sequencing (WES) identified a pathogenic homozygous missense mutation of the GALC gene. Parents of the patient were heterozygous for the mutation. The clinical, electrophysiological, and radiological data of the patient were retrospectively analyzed. The patient was a 24-year-old woman presenting with generalized seizures, progressive cognitive decline, psychiatric symptoms, gait ataxia, and action-induced myoclonus. The brain magnetic resonance imaging (MRI) revealed a right occipital cortical ribbon sign without any other damage. This single case expands the clinical phenotypes of adult-onset KD.
Collapse
Affiliation(s)
- Yu Wang
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Su-yue Wang
- Department of Internal Medicine, Feidong County Hospital of Traditional Chinese Medicine, Hefei, China
| | - Kai Li
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
- *Correspondence: Kai Li
| | - Yu-long Zhu
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Kun Xia
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Dan-dan Sun
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Wen-long Ai
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Xiao-ming Fu
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Qun-rong Ye
- Department of Neurology, The Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Jun Li
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Huai-zhen Chen
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| |
Collapse
|
4
|
Sasaki M, Ebata M, Tanei ZI, Oda Y, Hamauchi A, Tanikawa S, Sugino H, Ishida Y, Abe T, Arai N, Sako K, Tanaka S. An autopsy case report of adult-onset Krabbe disease: Comparison with an infantile-onset case. Pathol Int 2022; 72:558-565. [PMID: 36200664 DOI: 10.1111/pin.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/14/2022] [Indexed: 11/27/2022]
Abstract
Krabbe disease is a lysosomal storage disease caused by a deficiency of the galactocerebrosidase (GALC) enzyme, which leads to demyelination of the central and peripheral nervous systems. Almost all patients with Krabbe disease are infants, and this is the first report of adult-onset cases that describe pathological findings. Here, we present two autopsy cases: a 73-year-old female and a 2-year-old male. The adult-onset case developed symptoms in her late thirties and was diagnosed by the identification of GALC D528N and L634S mutations and by T2-weighted magnetic resonance imaging; she had increased signal in the white matter along the pyramidal tract to the bilateral precentral gyrus, as well as from the triangular part to the posterior horn of the lateral ventricle. Microscopically, Klüver-Barrera staining was pale in the white matter of the precentral gyrus and occipito-thalamic radiation, and a few globoid cells were observed. The GALC mutations that were identified in the present adult-onset case do not completely inactivate GALC enzyme activity, resulting in focal demyelination of the brain.
Collapse
Affiliation(s)
- Miu Sasaki
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Miori Ebata
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Zen-Ichi Tanei
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshitaka Oda
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Akiko Hamauchi
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan.,Department of Internal Medicine & Neurology, Takeuchi Clinic, Doushoukai Medical Corporation, Setouchi, Japan
| | - Satoshi Tanikawa
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan.,Institute for Chemical Reaction Design and Discovery (WPI-ICReDD), Hokkaido University, Sapporo, Japan
| | - Hirokazu Sugino
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yusuke Ishida
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Takenori Abe
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Nobutaka Arai
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazuya Sako
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan.,Institute for Chemical Reaction Design and Discovery (WPI-ICReDD), Hokkaido University, Sapporo, Japan
| |
Collapse
|
5
|
Wu G, Li Z, Li J, Li X, Wang M, Zhang J, Liu G, Zhang P. A neglected neurodegenerative disease: Adult-onset globoid cell leukodystrophy. Front Neurosci 2022; 16:998275. [PMID: 36161165 PMCID: PMC9490374 DOI: 10.3389/fnins.2022.998275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Globoid cell leukodystrophy (GLD), or Krabbe disease (KD) is a rare neurodegenerative disease, and adult-onset GLD is more even neglected by clinicians. This review provides detailed discussions of the serum enzymes, genes, clinical manifestations, neuroimaging features, and therapies of GLD, with particular emphasis on the characteristics of adult-onset GLD, in an attempt to provide clinicians with in-depth insights into this disease.
Collapse
Affiliation(s)
- Guode Wu
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhenhua Li
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Li
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Xin Li
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Manxia Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
- *Correspondence: Manxia Wang,
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Guangyao Liu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Pengfei Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| |
Collapse
|
6
|
He Z, Pang X, Bai J, Wang H, Feng F, Du R, Huang X. A novel GALC gene mutation associated with adult-onset Krabbe disease: a case report. Neurocase 2022; 28:314-319. [PMID: 35654103 DOI: 10.1080/13554794.2022.2083518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To analyze the clinical, imaging, and genetic characteristics of a patient diagnosed with adult-onset Krabbe disease (KD). Clinical and imaging features of the patient were retrospectively reviewed. The patient, a 40-year-old female, presented adult-onset spastic paraplegia. Brain magnetic resonance imaging (MRI) showed white matter hyperintensities along bilateral optic radiations. Colorimetry of galactocerebrosidase enzyme activity showed low enzyme levels. A heterozygous missense mutation: c.1658G>A (p.G553E) and c.1901T>C (p.L634S) was identified in the GALC gene by whole exome sequencing, and was verified by Sanger sequencing. KD should be considered when patients presented adult-onset spastic paraplegia with classical MRI imaging features. Mutation c.1658G>A (p.G553E) was novel in GALC gene and broaden the mutation spectrum.
Collapse
Affiliation(s)
- Zhengqing He
- Chinese PLA Medical School, Beijing, China.,Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xinyuan Pang
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| | - Jiongming Bai
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| | - Haoran Wang
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| | - Feng Feng
- Department of Neurology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Rongrong Du
- Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| | - Xusheng Huang
- Chinese PLA Medical School, Beijing, China.,Department of Neurology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Medicine, Nankai University, Tianjin, China
| |
Collapse
|
7
|
Strovel ET, Cusmano-Ozog K, Wood T, Yu C. Measurement of lysosomal enzyme activities: A technical standard of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2022; 24:769-783. [PMID: 35394426 DOI: 10.1016/j.gim.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Assays that measure lysosomal enzyme activity are important tools for the screening and diagnosis of lysosomal storage disorders (LSDs). They are often ordered in combination with urine oligosaccharide and glycosaminoglycan analysis, additional biomarker assays, and/or DNA sequencing when an LSD is suspected. Enzyme testing in whole blood/leukocytes, serum/plasma, cultured fibroblasts, or dried blood spots demonstrating deficient enzyme activity remains a key component of LSD diagnosis and is often prompted by characteristic clinical findings, abnormal newborn screening, abnormal biochemical findings (eg, elevated glycosaminoglycans), or molecular results indicating pathogenic variants or variants of uncertain significance in a gene associated with an LSD. This document, which focuses on clinical enzyme testing for LSDs, provides a resource for laboratories to develop and implement clinical testing, to describe variables that can influence test performance and interpretation of results, and to delineate situations for which follow-up molecular testing is warranted.
Collapse
Affiliation(s)
- Erin T Strovel
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | | | - Tim Wood
- Section of Genetics and Metabolism, Department of Pediatrics, School of Medicine, Children's Hospital Colorado Anschutz Medical Campus, Aurora, CO
| | - Chunli Yu
- Department of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, NY; Sema4, Stamford, CT
| |
Collapse
|
8
|
A novel compound heterozygous mutation in GALC associated with adult-onset Krabbe disease: case report and literature review. Neurogenetics 2022; 23:157-165. [PMID: 35013804 DOI: 10.1007/s10048-021-00682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
Krabbe disease (KD) is a rare autosomal recessive lipid storage leukodystrophy. It is caused by deficient enzyme activity resulting from mutations of the β-galactocerebrosidase (GALC) gene. KD is distinguished into subtypes based on the age of onset; these are early infantile, late infantile, juvenile, and adult-onset. We report a case of a 47-year-old Caucasian man with a 2-year history of muscle atrophy and weakness in both hands associated with pyramidal signs and mild spasticity in the lower limbs. An extensive work-up led this motor neuron disease-like disorder to be diagnosed as adult-onset KD. The patient was found to be compound heterozygous for two GALC mutations (p.G286D and p.Y490N). These two rare missense mutations have previously been reported with other heterozygous mutations. However, their co-occurrence in a KD patient is novel. From the perspective of this case, we review the current literature on compound heterozygous mutations in adult-onset KD and their phenotypic variability.
Collapse
|
9
|
Comprehensive analysis of recessive carrier status using exome and genome sequencing data in 1543 Southern Chinese. NPJ Genom Med 2022; 7:23. [PMID: 35314707 PMCID: PMC8938515 DOI: 10.1038/s41525-022-00287-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/21/2022] [Indexed: 12/31/2022] Open
Abstract
Traditional carrier screening has been utilized for the detection of carriers of genetic disorders. Since a comprehensive assessment of the carrier frequencies of recessive conditions in the Southern Chinese population is not yet available, we performed a secondary analysis on the spectrum and carrier status for 315 genes causing autosomal recessive disorders in 1543 Southern Chinese individuals with next-generation sequencing data, 1116 with exome sequencing and 427 with genome sequencing data. Our data revealed that 1 in 2 people (47.8% of the population) was a carrier for one or more recessive conditions, and 1 in 12 individuals (8.30% of the population) was a carrier for treatable inherited conditions. In alignment with current American College of Obstetricians and Gynecologists (ACOG) pan-ethnic carrier recommendations, 1 in 26 individuals were identified as carriers of cystic fibrosis, thalassemia, and spinal muscular atrophy in the Southern Chinese population. When the >1% expanded carrier screening rate recommendation by ACOG was used, 11 diseases were found to meet the criteria in the Southern Chinese population. Approximately 1 in 3 individuals (35.5% of the population) were carriers of these 11 conditions. If the 1 in 200 carrier frequency threshold is used, and additional seven genes would meet the criteria, and 2 in 5 individuals (38.7% of the population) would be detected as a carrier. This study provides a comprehensive catalogue of the carrier spectrum and frequency in the Southern Chinese population and can serve as a reference for careful evaluation of the conditions to be included in expanded carrier screening for Southern Chinese people.
Collapse
|
10
|
Ghabash G, Wilkes J, Bonkowsky JL. National U.S. Patient and Transplant Data for Krabbe Disease. Front Pediatr 2021; 9:764626. [PMID: 34900869 PMCID: PMC8660087 DOI: 10.3389/fped.2021.764626] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Krabbe disease (KD) is a leukodystrophy caused by mutations in the galactosylceramidase gene. Presymptomatic hematopoietic stem cell transplantation (HSCT) is associated with improved outcomes, but most data are from single-center studies. Our objective was to characterize national patterns of HSCT for KD including whether there were disparities in HSCT utilization and outcomes. We conducted a retrospective study of KD patients ≤ age 18 years from November 1, 2015, through December 31, 2019, using the U.S. Children's Hospital Association's Pediatric Health Information System database. We evaluated outcomes for HSCT, intensive care unit days, and mortality, comparing age, sex, race/ethnicity, rural/urban location, and median household income. We identified 91 KD patients. HSCT, performed in 32% of patients, was associated with reduced mortality, 31 vs. 68% without HSCT (p < 0.003). Trends included the fact that more males than females had HSCT (39 vs. 23%); more Asian and White patients had HSCT compared to Black or Hispanic patients (75, 33, 25, and 17%, respectively); and patients from households with the lowest-income quartile (< $25,000) had more HSCT compared to higher-income quartiles (44 vs. 33, 30, and 0%). Overall, receiving HSCT was associated with reduced mortality. We noted trends in patient groups who received HSCT. Our findings suggest that disparities in receiving HSCT could affect outcomes for KD patients.
Collapse
Affiliation(s)
- Gabrielle Ghabash
- University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Jacob Wilkes
- Intermountain Healthcare, Salt Lake City, UT, United States
| | - Joshua L. Bonkowsky
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
- Primary Children's Center for Personalized Medicine, Primary Children's Hospital, Salt Lake City, UT, United States
| |
Collapse
|
11
|
Zhang X, Niu G, Song P, Wang L, Han R, Chu M, Guo Q, Xu Z, Yan L, Jia T. Compound heterozygous pathogenic variants in the GALC gene cause infant-onset Krabbe disease. Transl Pediatr 2021; 10:2552-2562. [PMID: 34765479 PMCID: PMC8578788 DOI: 10.21037/tp-21-403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/02/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Krabbe disease, also called globoid cell leukodystrophy, is an autosomal recessive disease caused by a deficiency of lysosomal galactocerebrosidase. Infantile Krabbe occurring before 12 months of age accounts for most cases. Typical clinical features include irritability, seizures, peripheral neuropathy, and progressive neurodegeneration. METHODS We collected and summarized the clinical and genetic data of an 8-month-old boy who demonstrated Krabbe disease onset at around 6 months. Potential pathogenic variants were screened by whole exome sequencing, and effects of candidate variants on alternative transcript and truncated protein were further validated at the RNA and protein level. RESULTS Galactocerebrosidase activity was nearly absent in his blood, and whole exome sequencing revealed compound heterozygous variants [NM_000153.4: (c.658C>T); (c.328+5G>T)] in galactosylceramidase (GALC). The variant c.328+5G>T was predicted to alter splicing, and the abnormal isoform transcript was validated by observation of abnormal RNA isoforms. The variant c.658C>T was predicted to cause truncation of the protein, which was validated by western blotting. CONCLUSIONS Our findings revealed compound heterozygous variants with solid experimental results for Krabbe disease and provides strong evidence for further Krabbe disease screening and clinical consulting. As a rare inherited systemic disorder, genetic variants in Krabbe disease should be investigated, as experimental validation for clinical diagnosis is needed.
Collapse
Affiliation(s)
- Xiaoli Zhang
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guohui Niu
- Department of Children Rehabilitation, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Panpan Song
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lijun Wang
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Han
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Manman Chu
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiliang Guo
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhao Xu
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lihong Yan
- Department of Medical Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tianming Jia
- Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
12
|
Fukazawa R, Takeuchi H, Oka N, Shibuya T, Sakai N, Fujii A. Adult Krabbe Disease That Was Successfully Treated with Intravenous Immunoglobulin. Intern Med 2021; 60:1283-1286. [PMID: 33191329 PMCID: PMC8112994 DOI: 10.2169/internalmedicine.6094-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Krabbe disease involves the accumulation of neurotoxic metabolites due to lysosomal galactocerebrosidase enzyme deficiency, which results in widespread demyelination of central and peripheral nerves. Generally, Krabbe disease presents as spastic paraplegia with a slow progressive course; however, some cases may show clinical symptoms similar to those of chronic inflammatory demyelinating polyneuropathy (CIDP). No previously reported studies have investigated the efficacy of intravenous immunoglobulin (IVIg) for treating Krabbe disease, and reporting a case involving IVIg treatment may be informative in the clinical setting. A 14-year-old girl who developed Guillain-Barré syndrome-like limb weakness was administered IVIg, and her limb weakness improved. At 16 years old, she developed abnormal sensory perception and weakness of both upper limbs. A nerve conduction study revealed demyelination, which led us to suspect CIDP. IVIg was administered, and her symptoms gradually improved. A nerve biopsy, enzyme activity, and genetic test results indicated adult Krabbe disease. In some cases, IVIg may be an effective treatment for Krabbe disease.
Collapse
Affiliation(s)
| | - Hiroki Takeuchi
- Department of Neurology, National Hospital Organization Minami Kyoto Hospital, Japan
| | - Nobuyuki Oka
- Department of Neurology, National Hospital Organization Minami Kyoto Hospital, Japan
| | - Toko Shibuya
- Department of Pediatrics, Osaka University Graduate School of Medicine, Japan
| | - Norio Sakai
- Child Healthcare and Genetic Science Laboratory, Division of Health Sciences, Osaka University Graduate School of Medicine, Japan
| | - Akihiro Fujii
- Department of Neurology, Saiseikai Shiga Hospital, Japan
| |
Collapse
|
13
|
Bascou NA, Beltran-Quintero ML, Escolar ML. Pathogenic Variants in GALC Gene Correlate With Late Onset Krabbe Disease and Vision Loss: Case Series and Review of Literature. Front Neurol 2020; 11:563724. [PMID: 33178108 PMCID: PMC7593573 DOI: 10.3389/fneur.2020.563724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Krabbe disease is an autosomal recessive demyelinating disorder resulting from deficiency of the lysosomal enzyme galactocerebrosidase. While blindness is often described as a characteristic finding of the disease, it is more common in the infantile phenotype, where vision loss typically arises in the late stages of disease. In comparison, reports of vision loss in late onset phenotypes are less well-described and may be subject to variation between genotypes. Methods: Charts of Krabbe patients with a confirmed diagnosis, who presented with substantial visual impairment, were retrospectively reviewed from a larger group of 199 Krabbe patients. Assessment of clinical status was obtained through review of neurological evaluations, neurodevelopmental assessments, ophthalmological evaluations, visual evoked potentials (VEP), electroretinogram (ERG), nerve conduction velocity (NCV) studies, auditory brainstem responses (ABR), and brain magnetic resonance imaging. Results: Five late onset patients with Krabbe disease (four juvenile and one late-infantile) were included. Three patients were homozygous for c.956A>G_p.Y319C, one was compound heterozygous for c.296+1G>T and c.956A>G_p.Y319C, and one was compound heterozygous for c.1186C>T_p.R396W and c.1901T>C_p.L634S. All patients were of Asian descent and presented initially with vision impairment. Notably, the patients did not present with marked appendicular spasticity or axial hypotonia and all five reached developmental milestones within the normal time frame. For neurophysiological testing, no patient showed abnormalities in NCV or ABR. However, abnormalities in VEP or ERG were seen in all patients. The one patient who underwent transplantation stabilized following treatment. Conclusions: Depending on their genotype, patients with late onset Krabbe disease may initially present with vision loss. Furthermore, patients with p.L634S and p.Y319C should be closely monitored for changes in vision and VEP. This knowledge will become increasingly important as physicians may otherwise overlook these signs and symptoms when monitoring children identified through newborn screening who have the variants described in this report.
Collapse
Affiliation(s)
- Nicholas A Bascou
- Program for the Study of Neurodevelopment in Rare Disorders and Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Maria L Beltran-Quintero
- Program for the Study of Neurodevelopment in Rare Disorders and Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Maria L Escolar
- Program for the Study of Neurodevelopment in Rare Disorders and Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| |
Collapse
|
14
|
Krieg SI, Krägeloh-Mann I, Groeschel S, Beck-Wödl S, Husain RA, Schöls L, Kehrer C. Natural history of Krabbe disease - a nationwide study in Germany using clinical and MRI data. Orphanet J Rare Dis 2020; 15:243. [PMID: 32912261 PMCID: PMC7488349 DOI: 10.1186/s13023-020-01489-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 08/05/2020] [Indexed: 12/04/2022] Open
Abstract
Background Krabbe disease or globoid cell leukodystrophy is a severe neurodegenerative disorder caused by a defect in the GALC gene leading to a deficiency of the enzyme ß-galactocerebrosidase. The aim of this work was to describe the natural disease course covering the whole spectrum of the disease. Methods Natural history data were collected with a standardized questionnaire, supplemented by medical record data. We defined different forms of the disease according to Abdelhalim et al. (2014). Developmental and disease trajectories were described based on the acquisition and loss of milestones as well as the time of first clearly identifiable symptoms and needs such as spasticity, seizures and tube feeding. MRI was assessed using the scoring system by Loes et al. (1999) and in addition a pattern recognition approach, based on Abdelhalim et al. (2014). Results Thirty-eight patients were identified, from 27 of these patients 40 MRIs were available; 30 (79%) had an infantile onset, showing first symptoms in their first year of life, almost all (27 out of 30) starting in the first six months. A later onset after the first year of life was observed in 8 patients (21%, range 18 months to 60 years). Irritability, abnormalities in movement pattern as well as general developmental regression were the first symptoms in the infantile group; disease course was severe with rapid progression, e.g. loss of visual fixation, need for tube feeding and then an early death. Gait disorders were the first symptoms in all patients of the later onset groups; progression was variable. The different forms of the disease were characterized by different MRI patterns (infantile: diffuse white matter involvement and cerebellar structures specifically affected, later onset: parieto-occipital white matter and splenium affected, adult: motor tracts specifically affected). Conclusion This is the first description of the natural history of Krabbe disease in a larger European cohort using developmental, clinical and MRI data. We would like to highlight the very different clinical and MRI characteristics of the later onset forms. These data are important for counselling affected patients and families and may serve as a basis for future treatment trials.
Collapse
Affiliation(s)
- Sarah Isabel Krieg
- Department of Child Neurology, Children's Hospital, University of Tübingen, Hoppe-Seyler-Str. 1, 72072, Tübingen, Germany
| | - Ingeborg Krägeloh-Mann
- Department of Child Neurology, Children's Hospital, University of Tübingen, Hoppe-Seyler-Str. 1, 72072, Tübingen, Germany.
| | - Samuel Groeschel
- Department of Child Neurology, Children's Hospital, University of Tübingen, Hoppe-Seyler-Str. 1, 72072, Tübingen, Germany.,Section for Experimental MR of the CNS, Department of Child Neurology and Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Stefanie Beck-Wödl
- Department of Medical Genetics, University Hospital Tübingen, Tübingen, Germany
| | - Ralf A Husain
- Department of Neuropediatrics, Jena University Hospital, Jena, Germany
| | - Ludger Schöls
- Clinical Neurogenetics Section, Department of Neurology, University of Tübingen, Tübingen, Germany
| | - Christiane Kehrer
- Department of Child Neurology, Children's Hospital, University of Tübingen, Hoppe-Seyler-Str. 1, 72072, Tübingen, Germany
| |
Collapse
|
15
|
Xia Z, Wenwen Y, Xianfeng Y, Panpan H, Xiaoqun Z, Zhongwu S. Adult-onset Krabbe disease due to a homozygous GALC mutation without abnormal signals on an MRI in a consanguineous family: A case report. Mol Genet Genomic Med 2020; 8:e1407. [PMID: 32677356 PMCID: PMC7507702 DOI: 10.1002/mgg3.1407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/08/2020] [Accepted: 07/01/2020] [Indexed: 01/19/2023] Open
Abstract
Background The most frequent and common form of Krabbe disease (KD) is early‐onset KD in infants, and late‐onset KD has been reported to be a rare disease. In the present study, we reported an adult‐onset KD patient in a consanguineous Chinese family. Methods Clinical and radiological data were collected for a family pedigree. The patient was diagnosed with late‐onset KD through next‐generation sequencing. The result was confirmed by Sanger sequencing. GALC enzyme activity was also examined by the colorimetry method. Both the grey matter volume (GMV) and white matter volume values were examined and compared with the average values from ten age‐matched normal controls. Moreover, we reviewed all the available KD studies on PubMed to understand the correlation between the phenotype and genotype of the identified mutation. Results The main manifestations of the proband were sudden onset seizures and cognitive decline. Mutation analysis of the GALC revealed a homozygous c.1901T>C mutation in exon 16, which resulted in an amino acid change in p.L634S. Sanger sequencing results showed that the homozygous mutation was inherited from the patient's parents, both of whom were revealed to be heterozygous carriers. Moreover, a decrease in GALC enzyme activity was also detected. However, no abnormal signals were found in the brain MRI. Further structural MRI analysis revealed a significantly decreased GMV in the proband compared to the normal controls. Moreover, it is of interest that all patients with the c.1901T>C mutation had late‐onset KD and were selected from Asian countries, especially Japan and China. Conclusions This patient with a homozygous GALC mutation expands the clinical presentation and characteristics of adult‐onset KD, as indicated by grey matter atrophy without abnormal white matter signals.
Collapse
Affiliation(s)
- Zhou Xia
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yin Wenwen
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu Xianfeng
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hu Panpan
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhu Xiaoqun
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sun Zhongwu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| |
Collapse
|
16
|
Meng X, Li Y, Lian Y, Li Y, Du L, Xie N, Wang C. A new compound heterozygous mutation in adult-onset Krabbe disease. Int J Neurosci 2020; 130:1267-1271. [PMID: 32064984 DOI: 10.1080/00207454.2020.1731504] [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] [Indexed: 10/25/2022]
Abstract
Purpose: Krabbe disease (KD) or globoid cell leukodystrophy is an autosomal recessive lysosomal disorder caused by a lack of the lysosomal enzyme galactocerebrosidase (GALC) because of mutations in GALC. Patients with KD exhibit a wide spectrum of clinical symptoms; therefore, their diagnosis can be challenging. We report the clinical features and gene mutations in a 48-year-oldpatient with adult-onset KD.Methods: We collected and analyzed clinical data of the patientwith a diagnosis of KD. Gene mutations were identified by whole exome sequencing.Results: We describe a case of adult-onset KD caused by a novel compound heterozygous mutation; a missense mutation, c. 1901 T > C (p. L634S); and a novel nonsense mutation, c.1005C > G (p. Y335X), in GALC. The disease onset started when the patient was 40 years old, and manifested as typical paralytic paraplegia. Magnetic resonance imaging indicated demyelination of the white matter, which is consistent with the typical symptoms of adult-onset KD. Biochemical analysis revealed GALC activity to be 1.5 nmol/17 h/mg protein, confirming its deficiency and KD diagnosis.Conclusions: Our findings provide evidence of a novel mutation, providing additional information toward to the GALC mutation database.
Collapse
Affiliation(s)
- Xianghe Meng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingjiao Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yujuan Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liyuan Du
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Nanchang Xie
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cui Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
17
|
Page KM, Stenger EO, Connelly JA, Shyr D, West T, Wood S, Case L, Kester M, Shim S, Hammond L, Hammond M, Webb C, Biffi A, Bambach B, Fatemi A, Kurtzberg J. Hematopoietic Stem Cell Transplantation to Treat Leukodystrophies: Clinical Practice Guidelines from the Hunter's Hope Leukodystrophy Care Network. Biol Blood Marrow Transplant 2019; 25:e363-e374. [PMID: 31499213 DOI: 10.1016/j.bbmt.2019.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 08/09/2019] [Accepted: 09/02/2019] [Indexed: 12/22/2022]
Abstract
The leukodystrophies are a heterogeneous group of inherited diseases characterized by progressive demyelination of the central nervous system leading to devastating neurologic symptoms and premature death. Hematopoietic stem cell transplantation (HSCT) has been successfully used to treat certain leukodystrophies, including adrenoleukodystrophy, globoid leukodystrophy (Krabbe disease), and metachromatic leukodystrophy, over the past 30 years. To date, these complex patients have primarily been transplanted at a limited number of pediatric centers. As the number of cases identified through pregnancy and newborn screening is increasing, additional centers will be required to treat these children. Hunter's Hope created the Leukodystrophy Care Network in part to create and standardize high-quality clinical practice guidelines to guide the care of affected patients. In this report the clinical guidelines for the care of pediatric patients with leukodystrophies undergoing treatment with HSCT are presented. The initial transplant evaluation, determination of patient eligibility, donor selection, conditioning, supportive care, and post-transplant follow-up are discussed. Throughout these guidelines the need for early detection and treatment and the role of the partnership between families and multidisciplinary providers are emphasized.
Collapse
Affiliation(s)
- Kristin M Page
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina.
| | - Elizabeth O Stenger
- Aflac Cancer & Blood Disorders Center, Children's Hospital of Atlanta/Emory University
| | - James A Connelly
- Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, Tennessee
| | - David Shyr
- Division of Pediatric Hematology/Oncology, University of Utah School of Medicine
| | - Tara West
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina
| | - Susan Wood
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina
| | - Laura Case
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina
| | - Maureen Kester
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina
| | - Soo Shim
- Ann & Robert H. Lurie Children's Hospital, Chichago, Illinois
| | - Lauren Hammond
- Leukodystrophy Care Network Steering Committee, Orchard Park, New York
| | - Matthew Hammond
- Leukodystrophy Care Network Steering Committee, Orchard Park, New York
| | - Christin Webb
- Leukodystrophy Care Network Steering Committee, Orchard Park, New York
| | - Alessandra Biffi
- Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | | | - Ali Fatemi
- Moser Center for Leukodystrophies, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Maryland
| | - Joanne Kurtzberg
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina
| |
Collapse
|
18
|
Zhuang S, Kong L, Li C, Chen L, Zhang T. GALC mutations in Chinese patients with late-onset Krabbe disease: a case report. BMC Neurol 2019; 19:122. [PMID: 31185936 PMCID: PMC6560759 DOI: 10.1186/s12883-019-1345-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/24/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Krabbe disease (also known as globoid cell leukodystrophy) cause by a deficiency of the enzyme β-galactocerebrosidase (galactosylceramidase, GALC). The deficiency of GALC leads to accumulation of galactosylceramide and psychosine, the latter GALC substrate having a potential role in triggering demyelination. Typically, the disease has an infantile onset, with rapid deterioration in the first few months, leading to death before the age of 2 years. The late onset forms (late-infantile, juvenile, and adult forms) are rare with variable clinical outcomes, presenting spastic paraplegia as the main symptom. CASE PRESENTATION We recruited a family with two affected individuals. The proband (Patient 1), a 25-year-old male, was presented with slow progressive symptoms, including spastic gait disturbance and vision loss since the 5th year of life. His elder sister (Patient 2), became wheelchair-bound and demented at the age of 22 years. Brain magnetic resonance imaging (MRI) showed increased signal intensity in the white matter along with the involvement of the bilateral corticospinal tracts. GALC deficiency was confirmed by biochemical analysis. DNA sequencing revealed two mutations (c.865G > C: p. G289R and c.136G > T: p. D46Y) in GALC. The clinical characteristics, brain MRI, biochemical and molecular findings led to the diagnosis of Krabbe disease. CONCLUSION Clinical and neuroimaged signs, positive enzymatic analysis and molecular data converged to definite diagnosis in this neurodegenerative disease.
Collapse
Affiliation(s)
- Shunzhi Zhuang
- Department of Neurology, the First People's Hospital of Huizhou city, 20# Sanxin south Road, Huizhou, 516003, Guangdong Province, China
| | - Lingen Kong
- Department of Neurology, the First People's Hospital of Huizhou city, 20# Sanxin south Road, Huizhou, 516003, Guangdong Province, China
| | - Caiming Li
- Department of Neurology, the First People's Hospital of Huizhou city, 20# Sanxin south Road, Huizhou, 516003, Guangdong Province, China.
| | - Likun Chen
- Department of Neurology, the First People's Hospital of Huizhou city, 20# Sanxin south Road, Huizhou, 516003, Guangdong Province, China
| | - Tingting Zhang
- Department of Neurology, the First People's Hospital of Huizhou city, 20# Sanxin south Road, Huizhou, 516003, Guangdong Province, China
| |
Collapse
|
19
|
Maegawa GH. Lysosomal Leukodystrophies Lysosomal Storage Diseases Associated With White Matter Abnormalities. J Child Neurol 2019; 34:339-358. [PMID: 30757954 PMCID: PMC6459700 DOI: 10.1177/0883073819828587] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The leukodystrophies are a group of genetic metabolic diseases characterized by an abnormal development or progressive degeneration of the myelin sheath. The myelin is a complex sheath composed of several macromolecules covering axons as an insulator. Each of the leukodystrophies is caused by mutations in genes encoding enzymes that are involved in myelin production and maintenance. The lysosomal storage diseases are inborn disorders of compartmentalized cellular organelles with broad clinical manifestations secondary to the progressive accumulation of undegraded macromolecules within lysosomes and related organelles. The more than 60 different lysosomal storage diseases are rare diseases; however, collectively, the incidence of lysosomal storage diseases ranges just over 1 in 2500 live births. The majority of lysosomal storage diseases are associated with neurologic manifestations including developmental delay, seizures, acroparesthesia, motor weakness, and extrapyramidal signs. These inborn organelle disorders show wide clinical variability affecting individuals from all age groups. In addition, several of neurologic, also known as neuronopathic, lysosomal storage diseases are associated with some level of white matter disease, which often triggers the diagnostic investigation. Most lysosomal storage diseases are autosomal recessively inherited and few are X-linked, with females being at risk of presenting with mild, but clinically relevant neurologic manifestations. Biochemical assays are the basis of the diagnosis and are usually confirmed by molecular genetic testing. Novel therapies have emerged. However, most affected patients with lysosomal storage diseases have only supportive management to rely on. A better understanding of the mechanisms resulting in the leukodystrophy will certainly result in innovative and efficacious disease-modifying therapies.
Collapse
Affiliation(s)
- Gustavo H.B. Maegawa
- University of Florida, Department of Pediatrics/Genetics
& Metabolism, Gainesville, FL 32608, USA
| |
Collapse
|
20
|
Development of a newborn screening tool based on bivariate normal limits: using psychosine and galactocerebrosidase determination on dried blood spots to predict Krabbe disease. Genet Med 2018; 21:1644-1651. [DOI: 10.1038/s41436-018-0371-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/07/2018] [Indexed: 11/08/2022] Open
|
21
|
Irahara-Miyana K, Enokizono T, Ozono K, Sakai N. Exonic deletions in GALC are frequent in Japanese globoid-cell leukodystrophy patients. Hum Genome Var 2018; 5:28. [PMID: 30323943 PMCID: PMC6173723 DOI: 10.1038/s41439-018-0027-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/01/2018] [Indexed: 11/09/2022] Open
Abstract
Globoid-cell leukodystrophy is an autosomal-recessive lysosomal storage disorder. Single-base substitutions and small indel mutations in the GALC gene are common in Japanese patients. In this study, we identified three novel deletions, in exons 1, 8, and 11-12, in three patients using Multiplex Ligation-dependent Probe Amplification. We suggest that some patients in whom no or only a single pathogenic mutation is detected by Sanger sequencing may have exon deletions.
Collapse
Affiliation(s)
- Kaori Irahara-Miyana
- 1Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Enokizono
- 2Department of Pediatrics, University of Tsukuba Hospital, Ibaraki, Japan
| | - Keiichi Ozono
- 1Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norio Sakai
- 3Child Healthcare and Genetic Science, Department of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
22
|
Tuncer FN, Iseri SAU, Yapici Z, Demir M, Karaca M, Calik M. A novel homozygous GALC variant has been associated with Krabbe disease in a consanguineous family. Neurol Sci 2018; 39:2123-2128. [PMID: 30209698 DOI: 10.1007/s10072-018-3556-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/04/2018] [Indexed: 11/26/2022]
Abstract
Krabbe disease (KD) or globoid cell leukodystrophy is an autosomal recessive lysosomal storage disorder involving the white matter of the peripheral and the central nervous systems. It is caused by a deficiency of galactocerebrosidase enzyme activity. The most common manifestation is the classical early onset KD that leads to patient's loss before the age of 2. Herein, we report the evaluation of a consanguineous family with three affected children manifesting severe neurological findings that ended with death before the age of 2, in an attempt to provide genetic diagnosis to the family. One of the children underwent detailed physical and neurological examinations, including brain magnetic resonance imaging (MRI) and scalp electroencephalography (EEG) evaluations. GALC genetic testing on this child enabled identification of a novel homozygous variant (NM_000153.3: c.1394C>T; p.(Thr465Ile)), which confirmed diagnosis as KD. Familial segregation of this variant was performed by PCR amplification and Sanger sequencing that revealed the parents as heterozygous carriers. We believe this novel GALC variant will not only help in genetic counseling to this family but will also aid in identification of future KD cases.
Collapse
Affiliation(s)
- Feyza Nur Tuncer
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakif Gureba Cad., 34093, Fatih/Istanbul, Turkey.
| | - Sibel Aylin Ugur Iseri
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Vakif Gureba Cad., 34093, Fatih/Istanbul, Turkey
| | - Zuhal Yapici
- Division of Child Neurology, Department of Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mahmut Demir
- Department of Pediatrics, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Meryem Karaca
- Pediatric Metabolism Disorder Department, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Mustafa Calik
- Department of Pediatric Neurology, Harran University Faculty of Medicine, Sanliurfa, Turkey
| |
Collapse
|
23
|
Hossain MA, Miyajima T, Akiyama K, Eto Y. A Case of Adult-onset Pompe Disease with Cerebral Stroke and Left Ventricular Hypertrophy. J Stroke Cerebrovasc Dis 2018; 27:3046-3052. [PMID: 30093193 DOI: 10.1016/j.jstrokecerebrovasdis.2018.06.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/26/2018] [Accepted: 06/30/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pompe disease is an autosomal recessive glycogen storage disorder caused by a deficiency of the lysosomal glycogen-hydrolyzing enzyme acid α-glucosidase. The adult-onset form, late-onset Pompe disease, has been characterized by glycogen accumulation, primarily in skeletal and smooth muscles, causing weakness of the proximal limb girdle and respiratory compromises. CASE REPORT A 59-year-old female was admitted to the hospital with acute cerebral stroke at the age of 57years. Following her admission, conventional conservative stroke management followed by cerebral arterial clipping was performed. However, weakness of lower extremities, predominantly in the right side, and evening headache were persisting. After obtaining a careful past history, she noticed that she had a history of recurrent respiratory tract infection and she did not like any physical exercise in school. She also complained of gait disturbance since 32years of age. She had also been suffering from systemic hypertension since 40years of age. She had mild respiratory and swallowing difficulties. Her brain Magnetic Resonance (MR) revealed multiple infractions and white matter degeneration with irregular basilar arterial walls. A computed tomography (CT) scan of lower extremities showed diffuse fibrosis of the proximal muscles predominantly on the right thigh. Cardiac echocardiogram showed left ventricular hypertrophy. Electron microscopy of blood cells including lymphocytes and platelets and skin fibroblasts showed marked granular inclusions in lysosomes, suggesting glycogen accumulation. Her measured acid α-glucosidase activity was very low, 1.3 pmol hour-1 punch-1, and we found a homozygous splice-site mutation c.546G>T in the GAA gene. CONCLUSION Cerebral stoke as an initial finding for an adult-type Pompe disease is rare. Left ventricular hypertrophy is also rarely reported for adult onset of Pompe disease. This case will explore further ways to diagnose adult-onset Pompe disease.
Collapse
Affiliation(s)
- Mohammad Arif Hossain
- Advanced Clinical Research Center, Institute of Neurological Disorders, Kawasaki, Kanagawa, Japan; Department of Gene Therapy, Institute for deoxyribonucleic acid (DNA) Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Takashi Miyajima
- Advanced Clinical Research Center, Institute of Neurological Disorders, Kawasaki, Kanagawa, Japan
| | - Keiko Akiyama
- Advanced Clinical Research Center, Institute of Neurological Disorders, Kawasaki, Kanagawa, Japan
| | - Yoshikatsu Eto
- Advanced Clinical Research Center, Institute of Neurological Disorders, Kawasaki, Kanagawa, Japan; Department of Gene Therapy, Institute for deoxyribonucleic acid (DNA) Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| |
Collapse
|
24
|
Zhang T, Yan C, Ji K, Lin P, Chi L, Zhao X, Zhao Y. Adult-onset Krabbe disease in two generations of a Chinese family. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:174. [PMID: 29951496 DOI: 10.21037/atm.2018.04.30] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Krabbe disease (KD) is a rare autosomal recessive lysosomal storage disorder caused by deficiency of the galactocerebrosidase (GALC) enzyme. The adult-onset KD is infrequent, and often presenting with slowly progressive spastic paraplegia. Herein, we describe a two-generation concomitant Chinese pedigree of adult-onset KD in which the proband presented with acute hemiplegia at onset. Methods We collected the clinical and neuroimaging data of the pedigree. GALC enzyme activity detection and gene analysis were performed to confirm the diagnosis. Moreover, we reviewed all studies available on PubMed to understand the correlationship between phenotype and genotype of the identified mutations. Results The proband presented with sudden-onset weakness of left limbs with selective pyramidal tract involvement on diffusion-weighted imaging (DWI) of brain MRI. The GALC enzyme activity of him was low, and the GALC gene analysis revealed compound heterozygous pathogenic mutations of c.1901T>C and c.1901delT. More interestingly, the homozygous c.1901T>C mutations were found in the proband's asymptomatic father and two paternal uncles. Meanwhile, the literature review revealed the c.1901T>C mutation was only found in the late-onset form of KD. Conclusions These observations, combined with previous reports, indicate that KD should be considered in the adult patients presenting selective pyramidal tract impairment even with sudden onset.
Collapse
Affiliation(s)
- Tongxia Zhang
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Chuanzhu Yan
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, China.,Brain Science Research Institute, Qilu Hospital, Shandong University, Jinan 250012, China.,Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Shandong University, Qingdao 266035, China
| | - Kunqian Ji
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Pengfei Lin
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Lingyi Chi
- Brain Science Research Institute, Qilu Hospital, Shandong University, Jinan 250012, China.,Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Xiuhe Zhao
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Yuying Zhao
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, China
| |
Collapse
|
25
|
Irahara-Miyana K, Otomo T, Kondo H, Hossain MA, Ozono K, Sakai N. Unfolded protein response is activated in Krabbe disease in a manner dependent on the mutation type. J Hum Genet 2018; 63:699-706. [PMID: 29615819 DOI: 10.1038/s10038-018-0445-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/23/2018] [Accepted: 02/27/2018] [Indexed: 02/08/2023]
Abstract
Krabbe disease, one of the autosomal-recessive lysosomal storage disorders (LSDs), is caused by a deficiency of galactocerebrosidase (GALC) activity, resulting in the intracellular accumulation of psychosine, which is cytotoxic for neuronal cells. Genetically pathogenic mutations result in conformational changes in GALC and disrupt the lysosmal trafficking of cargos, which subsequently accumulate in the endoplasmic reticulum (ER). Recently, ER stress together with the activation of the unfolded protein response (UPR) has been suggested to play a key role in the pathogenesis of LSDs. In this study, we hence investigated whether the UPR is activated in Krabbe disease using COS-7 cells expressing pathogenic GALC mutants and skin fibroblasts (SFs) from Krabbe disease patients with various phenotypes, using a combination of semiquantitative and quantitative real-time polymerase chain reactions. We found that UPR activation in Krabbe disease depends on the mutations and cell types, and there is the possibility that multiple pathways, involving ER chaperones, inositol-requiring kinase 1, and protein kinase regulated by RNA-like ER kinase are activated by mutations associated with the infantile form. These results indicate that in Krabbe disease, each misfolded/unfolded protein evokes different UPR activation depending on the mutation, and that the activated pathways affect the phenotypes.
Collapse
Affiliation(s)
- Kaori Irahara-Miyana
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takanobu Otomo
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Pathophysiology and Metabolism, Kawasaki Medical School, Okayama, Japan
| | - Hidehito Kondo
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mohammad Arif Hossain
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kanagawa, Japan.,Department of Gene Therapy, Institute for DNA Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norio Sakai
- Department of Health Science, Child Healthcare and Genetic Science, Osaka University Graduate School of Medicine, Osaka, Japan.
| |
Collapse
|
26
|
Lim SM, Choi BO, Oh SI, Choi WJ, Oh KW, Nahm M, Xue Y, Choi JH, Choi JY, Kim YE, Chung KW, Fu XD, Ki CS, Kim SH. Patient fibroblasts-derived induced neurons demonstrate autonomous neuronal defects in adult-onset Krabbe disease. Oncotarget 2018; 7:74496-74509. [PMID: 27780934 PMCID: PMC5342682 DOI: 10.18632/oncotarget.12812] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 10/14/2016] [Indexed: 01/29/2023] Open
Abstract
Krabbe disease (KD) is an autosomal recessive neurodegenerative disorder caused by defective β-galactosylceramidase (GALC), a lysosomal enzyme responsible for cleavage of several key substrates including psychosine. Accumulation of psychosine to the cytotoxic levels in KD patients is thought to cause dysfunctions in myelinating glial cells based on a comprehensive study of demyelination in KD. However, recent evidence suggests myelin-independent neuronal death in the murine model of KD, thus indicating defective GALC in neurons as an autonomous mechanism for neuronal cell death in KD. These observations prompted us to generate induced neurons (iNeurons) from two adult-onset KD patients carrying compound heterozygous mutations (p.[K563*];[L634S]) and (p.[N228_S232delinsTP];[G286D]) to determine the direct contribution of autonomous neuronal toxicity to KD. Here we report that directly converted KD iNeurons showed not only diminished GALC activity and increased psychosine levels, as expected, but also neurite fragmentation and abnormal neuritic branching. The lysosomal-associated membrane proteins 1 (LAMP1) was expressed at higher levels than controls, LAMP1-positive vesicles were significantly enlarged and fragmented, and mitochondrial morphology and its function were altered in KD iNeurons. Strikingly, we demonstrated that psychosine was sufficient to induce neurite defects, mitochondrial fragmentation, and lysosomal alterations in iNeurons derived in healthy individuals, thus establishing the causal effect of the cytotoxic GALC substrate in KD and the autonomous neuronal toxicity in KD pathology.
Collapse
Affiliation(s)
- Su Min Lim
- Biomedical Research Institute, Hanyang University, Seoul, Republic of Korea.,Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea
| | - Byung-Ok Choi
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seong-Il Oh
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Won Jun Choi
- Department of Neurology, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates
| | - Ki-Wook Oh
- Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea.,Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Minyeop Nahm
- Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea
| | - Yuanchao Xue
- Key Laboratory of RNA Biology, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Jae Hyeok Choi
- Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea
| | - Ji Young Choi
- Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea
| | | | - Ki Wha Chung
- Department of Biological Sciences, Gongju National University, Gongju, Republic of Korea
| | - Xiang-Dong Fu
- Department of Cellular Molecular Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Chang-Seok Ki
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seung Hyun Kim
- Cell Therapy Center, Hanyang University Hospital, Seoul, Republic of Korea.,Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| |
Collapse
|
27
|
Okada J, Hossain MA, Wu C, Miyajima T, Yanagisawa H, Akiyama K, Eto Y. Ten-year-long enzyme replacement therapy shows a poor effect in alleviating giant leg ulcers in a male with Fabry disease. Mol Genet Metab Rep 2017; 14:68-72. [PMID: 29326878 PMCID: PMC5758919 DOI: 10.1016/j.ymgmr.2017.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 11/25/2022] Open
Abstract
Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency of α-galactosidase A (α-gal A), leading to the progressive accumulation of glycosphingolipids. Classical hemizygous males usually present symptoms, including pain and paresthesia in the extremities, angiokeratoma, hypo- or anhidrosis, abdominal pain, cornea verticillata, early stroke, tinnitus, and/or hearing loss, during early childhood or adolescence. Moreover, proteinuria, renal impairment, and cardiac hypertrophy can appear with age. Enzyme replacement is the most common therapy for Fabry disease at present which has been approved in Japan since 2004. We report a case involving a 27-year-old male with extreme terminal pain, anhidrosis, abdominal pain, tinnitus, hearing impairment, cornea verticillata, and recurrent huge ulcers in the lower extremities. At the age of 16 years, he was diagnosed with Fabry disease with a positive family history and very low α-gal A activity. He then received enzyme replacement therapy (ERT) with recombinant human agalsidase beta at 1 mg/kg every 2 weeks for 10 years. Throughout the course of ERT, his leg ulcers recurred, and massive excretion of urinary globotriaosylceramide and plasma globotriaosylsphingosine was observed. Electron microscopy of the venous tissue in the regions of the ulcer showed massive typical zebra bodies in the vascular wall smooth muscle cells. A classical hemizygous male with Fabry disease presented with massive intractable leg ulcer. 10 years' enzyme replacement therapy showed huge excretion of urinary Gb3 and plasma lyso-Gb3. Excessive zebra bodies in vascular wall smooth muscle cells caused venous reflux and varices on saphenous veins.
Collapse
Affiliation(s)
- Jun Okada
- Asakadai Central General Hospital, Asaka City, Japan
| | - Mohammad Arif Hossain
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan.,Department of Gene Therapy, Institute for DNA Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Chen Wu
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Takashi Miyajima
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Hiroko Yanagisawa
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Keiko Akiyama
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Yoshikatsu Eto
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan.,Department of Gene Therapy, Institute for DNA Medicine, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
28
|
Sakai N, Otomo T. Challenge of phenotype estimation for optimal treatment of Krabbe disease. J Neurosci Res 2017; 94:1025-30. [PMID: 27638587 DOI: 10.1002/jnr.23914] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/31/2016] [Accepted: 08/11/2016] [Indexed: 11/08/2022]
Abstract
Krabbe disease is an autosomal recessive, inherited demyelinating disease caused by deficiency of the lysosomal enzyme galactocerebrosidase. It is recognized as one of the predominant genetic diseases showing leukodystrophy from infancy to adulthood. The clinical phenotype and genotype for this disease show considerable variation worldwide, which makes accurate diagnosis difficult. Effective therapy is limited, although hematopoietic stem cell transplantation at an early stage has been established to some extent. We report here the long-term clinical effect on juvenile Krabbe disease for two brothers who underwent hematopoietic stem cell transplantation at an early stage of their disease. We review research into genotype-phenotype correlation for the possibility of early diagnosis at a presymptomatic stage. Medical care for this intractable disease will improve in the near future as a result of the increasing awareness of its molecular pathology and improvements in medical treatment. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Norio Sakai
- Child Healthcare and Genetic Science Laboratory, Division of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Takanobu Otomo
- Department of Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
29
|
Dai L, Han T, Yang X, Wang X, Li J, Lu J, Zhang W, Ren X, Fang F. WITHDRAWN: Clinical and molecular analysis of six novel GALC mutations identified in 7 Chinese children with Krabbe disease. Brain Dev 2017:S0387-7604(17)30145-6. [PMID: 28552323 DOI: 10.1016/j.braindev.2017.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/28/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
Collapse
Affiliation(s)
- Lifang Dai
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Tongli Han
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Xinying Yang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Xu Wang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Jiuwei Li
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Junlan Lu
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Wuchang Zhang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Xiaotun Ren
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
| | - Fang Fang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
| |
Collapse
|
30
|
Hossain MA, Yanagisawa H, Miyajima T, Wu C, Takamura A, Akiyama K, Itagaki R, Eto K, Iwamoto T, Yokoi T, Kurosawa K, Numabe H, Eto Y. The severe clinical phenotype for a heterozygous Fabry female patient correlates to the methylation of non-mutated allele associated with chromosome 10q26 deletion syndrome. Mol Genet Metab 2017; 120:173-179. [PMID: 28087245 DOI: 10.1016/j.ymgme.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 11/18/2022]
Abstract
Heterozygous Fabry females usually have an attenuated form of Fabry disease, causing them to be symptomatic; however, in rare cases, they can present with a severe phenotype. In this study, we report on a 37-year-old woman with acroparesthesia, a dysmorphic face, left ventricular hypertrophy, and intellectual disability. Her father had Fabry disease and died due to chronic renal and congestive cardiac failure. Her paternal uncle had chronic renal failure and intellectual disability, and her paternal aunt was affected with congestive cardiac failure. The patient has two sisters with no significant medical illness. However, her nephew has acroparesthesia, anhidrosis, and school phobia, and her niece shows mild phenotypes. The patient's enzyme analysis showed very low α-galactosidase A (α-gal A) activity in dried blood spot (DBS), lymphocytes, and skin fibroblasts with massive excretion of Gb3 and Gb2 in urine and lyso-Gb3 in DBS and plasma. Electron microscopic examination showed a large accumulation of sphingolipids in vascular endothelial cells and keratinocytes. Chromosomal analysis and comparative genomic hybridization microarray showed 10q26 terminal deletion. Molecular data showed a novel heterozygous stop codon mutation in exon 1 of the GLA gene in her sisters and niece, and a hemizygous state in her nephew. When we checked the methylation status, we found her non-mutated allele in the GLA gene was methylated. However, the non-mutated alleles of her sisters were non-methylated, and those of her niece were partially methylated. The chromosomal and methylation study may speculate the severity of her clinical phenotypes.
Collapse
Affiliation(s)
- Mohammad Arif Hossain
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan.
| | - Hiroko Yanagisawa
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Takashi Miyajima
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Chen Wu
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Ayumi Takamura
- Department of Biological Regulation School of Health Science, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Keiko Akiyama
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Rina Itagaki
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Kaoru Eto
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Takeo Iwamoto
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan; Core Research Facilities for Basic Science, The Jikei University School of Medicine, Tokyo, Japan
| | - Takayuki Yokoi
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Kenji Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Hironao Numabe
- Department of Genetic Counselling, Natural Science Division, Faculty of Core Research, Ochanomizu University, Tokyo, Japan
| | - Yoshikatsu Eto
- Advanced Clinical Research Center, Institute of Neurological Disorders, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan; Department of Gene Therapy, Institute for DNA Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| |
Collapse
|
31
|
Yoshimura A, Kibe T, Irahara K, Sakai N, Yokochi K. Predominant Corticospinal Tract Involvement in a Late Infant with Krabbe Disease. JAPANESE CLINICAL MEDICINE 2016; 7:23-6. [PMID: 27679535 PMCID: PMC5027888 DOI: 10.4137/jcm.s40470] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/14/2016] [Accepted: 08/17/2016] [Indexed: 11/06/2022]
Abstract
A case of late-infantile Krabbe disease in a patient who presented with developmental regression and spastic quadriplegia in late infancy is reported. Brain magnetic resonance imaging (MRI) at 11 months of age showed predominant corticospinal tract involvement, which usually appears in adult Krabbe disease. Galactocerebrosidase activity in lymphocytes and skin fibroblasts was very low. Genetic testing revealed compound heterozygous mutations of the galactocerebrosidase (GALC) gene, c.635_646 delinsCTC and c.1901T>C [p.L618S], both of which are known pathogenic mutations. It has been reported that the c.1901T>C [p.L618S] mutation is associated with the late-onset phenotype and, in a past case, a homozygous mutation at this location showed predominant corticospinal tract involvement on MRI. Although further analysis is needed to identify the pathophysiological mechanism, this combination of mutations is likely to be associated with this unusual MRI finding in late-infantile Krabbe disease. Because these types of mutations are common for Japanese patients, it is possible that there are more undiagnosed and late-diagnosed patients of late-infantile Krabbe disease who display limited lesions on MRI. Pediatricians should be aware that patients with late-infantile Krabbe disease can present with predominant corticospinal tract involvement on MRI.
Collapse
Affiliation(s)
- Ayumi Yoshimura
- Department of Pediatrics and Pediatric Neurology, Seirei-Mikatahara General Hospital, Shizuoka, Japan
| | - Tetsuya Kibe
- Department of Pediatrics and Pediatric Neurology, Seirei-Mikatahara General Hospital, Shizuoka, Japan
| | - Kaori Irahara
- Department of Pediatrics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Norio Sakai
- Department of Pediatrics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kenji Yokochi
- Department of Pediatrics and Pediatric Neurology, Seirei-Mikatahara General Hospital, Shizuoka, Japan
| |
Collapse
|
32
|
Mamada N, Nakamagoe K, Shioya A, Furuta J, Sakai N, Ishii A, Tamaoka A. Adult-onset Krabbe disease presenting as acute hemiparesis and progressive demyelination detected by diffusion-weighted imaging. J Neurol Sci 2016; 367:326-8. [PMID: 27423612 DOI: 10.1016/j.jns.2016.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/08/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Naomi Mamada
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Kiyotaka Nakamagoe
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan.
| | - Ayako Shioya
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Junichi Furuta
- Department of Dermatology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Norio Sakai
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Suita, Japan
| | - Akiko Ishii
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Akira Tamaoka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| |
Collapse
|
33
|
Altered Trafficking and Processing of GALC Mutants Correlates with Globoid Cell Leukodystrophy Severity. J Neurosci 2016; 36:1858-70. [PMID: 26865610 DOI: 10.1523/jneurosci.3095-15.2016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Globoid cell leukodystrophy (GLD, Krabbe disease) is due to autosomal recessive mutations in the lysosomal enzyme galactosylceramidase (GALC). Many GLD patients develop infantile-onset of progressive neurologic deterioration and death by 2 years of age, whereas others have a later-onset, milder disease. Cord blood transplant slows disease progression much more effectively when performed presymptomatically, highlighting the importance of early diagnosis. Current diagnosis is based on reduced GALC activity, DNA sequence, and clinical examination. However, presymptomatic diagnosis is hampered by imperfect genotype-GALC activity-phenotype correlations. In addition, three polymorphisms in the GALC gene are variably associated with disease mutations and have unknown effects on GALC activity and disease outcome. Here, we study mutations that cause infantile or later-onset GLD, and show that GALC activity is significantly lower in infantile versus later-onset mutants when measured in the lysosomal fraction, but not in whole-cell lysates. In parallel, infantile-onset mutant GALCs showed reduced trafficking to lysosomes and processing than later-onset mutant GALCs. Finally, the cis-polymorphisms also affected trafficking to the lysosome and processing of GALC. These differences potentially explain why the activity of different mutations appears similar in whole-cell extracts from lymphocytes, and suggest that measure of GALC activity in lysosomes may better predict the onset and severity of disease for a given GLD genotype. SIGNIFICANCE STATEMENT Globoid cell leukodystrophy (GLD, Krabbe disease) is diagnosed by measuring galactosylceramidase (GALC) activity and DNA analysis. However, genotype and phenotype often do not correlate due to considerable clinical variability, even for the same mutation, for unknown reasons. We find that altered trafficking to the lysosome and processing of GALC correlates with GLD severity and is modulated by cis-polymorphisms. Current diagnosis of GLD is based on GALC activity of total cell lysates from blood, which does not discriminate whether the activity comes from the lysosome or other subcellular organelles. Measurement of GALC activity in lysosomes may predict which infants are at high risk for the infantile phenotype while distinguishing other children who will develop later-onset phenotypes without onset of symptoms for years.
Collapse
|
34
|
Spratley SJ, Hill CH, Viuff AH, Edgar JR, Skjødt K, Deane JE. Molecular Mechanisms of Disease Pathogenesis Differ in Krabbe Disease Variants. Traffic 2016; 17:908-22. [PMID: 27126738 PMCID: PMC4949656 DOI: 10.1111/tra.12404] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/11/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
Abstract
Krabbe disease is a severe, fatal neurodegenerative disorder caused by defects in the lysosomal enzyme galactocerebrosidase (GALC). The correct targeting of GALC to the lysosome is essential for the degradation of glycosphingolipids including the primary lipid component of myelin. Over 100 different mutations have been identified in GALC that cause Krabbe disease but the mechanisms by which they cause disease remain unclear. We have generated monoclonal antibodies against full-length human GALC and used these to monitor the trafficking and processing of GALC variants in cell-based assays and by immunofluorescence microscopy. Striking differences in the secretion, processing and endosomal targeting of GALC variants allows the classification of these into distinct categories. A subset of GALC variants are not secreted by cells, not proteolytically processed, and remain trapped in the ER; these are likely to cause disease due to protein misfolding and should be targeted for pharmacological chaperone therapies. Other GALC variants can be correctly secreted by cells and cause disease due to catalytic defects in the enzyme active site, inappropriate post-translational modification or a potential inability to bind essential cofactors. The classification of disease pathogenesis presented here provides a molecular framework for appropriate targeting of future Krabbe disease therapies.
Collapse
Affiliation(s)
- Samantha J Spratley
- Cambridge Institute for Medical Research, Department of Pathology, University of Cambridge, Cambridge, CB2 0XY, UK
| | - Chris H Hill
- Cambridge Institute for Medical Research, Department of Pathology, University of Cambridge, Cambridge, CB2 0XY, UK.,Current address: MRC Laboratory of Molecular Biology, Cambridge, CB2 0QH, UK
| | - Agnete H Viuff
- Department of Chemistry, Aarhus University, Aarhus C, 8000, Denmark
| | - James R Edgar
- Cambridge Institute for Medical Research, Department of Clinical Biochemistry, University of Cambridge, Cambridge, CB2 0XY, UK
| | - Karsten Skjødt
- Department of Cancer and Inflammation, University of Southern Denmark, Odense, 5000, Denmark
| | - Janet E Deane
- Cambridge Institute for Medical Research, Department of Pathology, University of Cambridge, Cambridge, CB2 0XY, UK
| |
Collapse
|
35
|
Adachi H, Ishihara K, Tachibana H, Oka N, Higuchi Y, Takashima H, Yoneda Y, Kageyama Y. Adult-onset Krabbe disease presenting with an isolated form of peripheral neuropathy. Muscle Nerve 2016; 54:152-7. [DOI: 10.1002/mus.25067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Hiroshi Adachi
- Division of Neurology; Hyogo Prefectural Amagasaki General Medical Center; 2-17-77 East-Naniwa Amagasaki City Hyogo 660-8550 Japan
| | - Kanako Ishihara
- Division of Neurology; Hyogo Prefectural Amagasaki General Medical Center; 2-17-77 East-Naniwa Amagasaki City Hyogo 660-8550 Japan
| | - Hisatsugu Tachibana
- Department of Neurology; Kobe University Graduate School of Medicine; Kobe Japan
| | - Nobuyuki Oka
- Department of Neurology; National Hospital Organization Minami Kyoto Hospital; Kyoto Japan
| | - Yujiro Higuchi
- Department of Neurology and Geriatrics; Kagoshima University Graduate School of Medical and Dental Sciences; Kagoshima Japan
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics; Kagoshima University Graduate School of Medical and Dental Sciences; Kagoshima Japan
| | - Yukihiro Yoneda
- Division of Neurology; Hyogo Prefectural Amagasaki General Medical Center; 2-17-77 East-Naniwa Amagasaki City Hyogo 660-8550 Japan
| | - Yasufumi Kageyama
- Division of Neurology; Hyogo Prefectural Amagasaki General Medical Center; 2-17-77 East-Naniwa Amagasaki City Hyogo 660-8550 Japan
| |
Collapse
|
36
|
Hossain MA, Higaki K, Shinpo M, Nanba E, Suzuki Y, Ozono K, Sakai N. Chemical chaperone treatment for galactosialidosis: Effect of NOEV on β-galactosidase activities in fibroblasts. Brain Dev 2016; 38:175-80. [PMID: 26259553 DOI: 10.1016/j.braindev.2015.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/14/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Galactosialidosis is a rare lysosomal storage disease caused by a combined deficiency of GM1 β-galactosidase (β-gal) and neuraminidase secondary to a defect of a lysosomal enzyme protective protein/cathepsin A (PPCA) and mutation in CTSA gene. Three subtypes are recognized: early infantile, late infantile, and juvenile/adult. There is no specific therapy for patients with galactosialidosis at this time. OBJECTIVES The aim of this study was to determine the chaperone effect of N-octyl-4-epi-β-valienamine (NOEV) on β-gal proteins in skin fibroblasts of PPCA-deficit patients. METHODS β-Gal and neuraminidase activities were measured for the diagnosis of the patients with galactosialidosis. Western blotting for PPCA protein and direct sequencing for CTSA gene were performed. Cultured skin fibroblast were treated with NOEV. RESULTS We report four novel patients with galactosialidosis: one had the early infantile form and the other three had the juvenile/adult form. We found that NOEV stabilized β-gal activity in lysate from cultured skin fibroblasts from these patients. Treatment with NOEV significantly enhanced β-gal activity in cultured skin fibroblasts in the absence of PPCA. CONCLUSIONS Our results indicate the possibility that NOEV chaperone therapy might have a beneficial effect, at least in part, for patients with galactosialidosis.
Collapse
Affiliation(s)
- Mohammad Arif Hossain
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Katsumi Higaki
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, Yonago, Japan
| | - Michiko Shinpo
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Eiji Nanba
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, Yonago, Japan
| | | | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Norio Sakai
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| |
Collapse
|
37
|
Enzyme replacement therapy of a novel humanized mouse model of globoid cell leukodystrophy. Exp Neurol 2015; 271:36-45. [DOI: 10.1016/j.expneurol.2015.04.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 12/31/2022]
|
38
|
Hossain MA, Higaki K, Saito S, Ohno K, Sakuraba H, Nanba E, Suzuki Y, Ozono K, Sakai N. Chaperone therapy for Krabbe disease: potential for late-onset GALC mutations. J Hum Genet 2015; 60:539-45. [PMID: 26108143 DOI: 10.1038/jhg.2015.61] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/27/2015] [Accepted: 04/08/2015] [Indexed: 01/24/2023]
Abstract
Krabbe disease is an autosomal recessive leukodystrophy caused by a deficiency of the galactocerebrosidase (GALC) enzyme. Hematopoietic stem cells transplantation is the only available treatment option for pre-symptomatic patients. We have previously reported the chaperone effect of N-octyl-4-epi-β-valienamine (NOEV) on mutant GM1 β-galactosidase proteins, and in a murine GM1-gangliosidosis model. In this study, we examined its chaperone effect on mutant GALC proteins. We found that NOEV strongly inhibited GALC activity in cell lysates of GALC-transfected COS1 cells. In vitro NOEV treatment stabilized GALC activity under heat denaturation conditions. We also examined the effect of NOEV on cultured COS1 cells expressing mutant GALC activity and human skin fibroblasts from Krabbe disease patients: NOEV significantly increased the enzyme activity of mutants of late-onset forms. Moreover, we confirmed that NOEV could enhance the maturation of GALC precursor to its mature active form. Model structural analysis showed NOEV binds to the active site of human GALC protein. These results, for the first time, provide clear evidence that NOEV is a chaperone with promising potential for patients with Krabbe disease resulting from the late-onset mutations.
Collapse
Affiliation(s)
- Mohammad Arif Hossain
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Katsumi Higaki
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, Yonago, Japan
| | - Seiji Saito
- Department of Medical Management and Informatics, Hokkaido Information University, Hokkaido, Japan
| | - Kazuki Ohno
- NPO for the Promotion of Research on Intellectual Property Tokyo, Tokyo, Japan
| | - Hitoshi Sakuraba
- Department of Clinical Genetics, Meiji Pharmaceutical University, Tokyo, Japan
| | - Eiji Nanba
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, Yonago, Japan
| | | | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norio Sakai
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
39
|
Abstract
The autosomal recessive inherited Krabbe disease (KD) is a devastating pediatric lysosomal storage disorder affecting white matter of the brain. It is caused by mutations in the gene coding for the lysosomal enzyme galactocerebrosidase. While most patients present with symptoms within the first 6 months of life, others present later in life throughout adulthood. The early infantile form of KD (EIKD) is frequent in the Muslim Arab population in Israel, with a very high prevalence of approximately 1/100 to 1/150 live births. The homozygous variant c.1582G > A (p.D528N) was found to be responsible for EIKD in Palestinian Arab patients. KD was reported in different Arab countries with much lower frequency. While most Arab patients presented with EIKD, late infantile and late onset KD forms were also reported. Most Arab patients presented with variable symptoms ranging from EIKD to late onset KD, with variable clinical findings. Based on literature studies, this review focuses on the clinical and molecular findings of KD patients with Arab ancestry, and highlights the need for developing universal genetic screening programs to overcome the under-reported status of KD prevalence in Arabia. This is expected to improve the prognosis of the disease and promote targeted molecular diagnostics to the Arab patients.
Collapse
Affiliation(s)
- Hatem Zayed
- Department of Health Sciences, Biomedical Program, Qatar University, Doha, Qatar
| |
Collapse
|
40
|
Graziano ACE, Cardile V. History, genetic, and recent advances on Krabbe disease. Gene 2014; 555:2-13. [PMID: 25260228 DOI: 10.1016/j.gene.2014.09.046] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/18/2014] [Accepted: 09/19/2014] [Indexed: 12/20/2022]
Abstract
Krabbe disease or globoid cell leukodystrophy is one of the classic genetic lysosomal storage diseases with autosomal recessive inheritance that affects both central and peripheral nervous systems in several species including humans, rhesus macaques, dogs, mice, and sheep. Since its identification in 1916, lots of scientific investigations were made to define the cause, to evaluate the molecular mechanisms of the damage and to develop more efficient therapies inducing clinical benefit and ameliorating the patients' quality of life. This manuscript gives a historical overview and summarizes the new recent findings about Krabbe disease. Human symptoms and phenotypes, gene encoding for β-galactocerebrosidase and encoded protein were described. Indications about the classical mutations were reported and some specific mutations in restricted geographical area, like the north of Catania City (Italy), were added. Briefly, here we present a mix of past and present investigations on Krabbe disease in order to update the knowledge on its genetic history and molecular mechanisms and to move new scientific investigations.
Collapse
Affiliation(s)
| | - Venera Cardile
- Department of Bio-Medical Science - Physiology Section, University of Catania, Catania, Italy.
| |
Collapse
|
41
|
Lehman A, Stittrich AB, Glusman G, Zong Z, Li H, Eydoux P, Senger C, Lyons C, Roach JC, Patel M. Diffuse angiopathy in Adams-Oliver syndrome associated with truncating DOCK6 mutations. Am J Med Genet A 2014; 164A:2656-62. [PMID: 25091416 DOI: 10.1002/ajmg.a.36685] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 06/18/2014] [Indexed: 11/11/2022]
Abstract
Adams-Oliver syndrome (AOS) is a rare malformation syndrome characterized by the presence of two anomalies: aplasia cutis congenita of the scalp and transverse terminal limb defects. Many affected individuals also have additional malformations, including a variety of intracranial anomalies such as periventricular calcification in keeping with cerebrovascular microbleeds, impaired neuronal migration, epilepsy, and microcephaly. Cardiac malformations can be present, as can vascular dysfunction in the forms of cutis marmorata telangiectasia congenita, pulmonary vein stenoses, and abnormal hepatic microvasculature. Elucidated genetic causes include four genes in different pathways, leading to a model of AOS as a multi-pathway disorder. We identified an infant with mild aplasia cutis congenita and terminal transverse limb defects, developmental delay and a severe, diffuse angiopathy with incomplete microvascularization. Whole-genome sequencing documented two rare truncating variants in DOCK6, a gene associated with a type of autosomal recessive AOS that recurrently features periventricular calcification and impaired neurodevelopment. We highlight an unexpectedly high frequency of likely deleterious mutations in this gene in the general population, relative to the rarity of the disease, and discuss possible explanations for this discrepancy.
Collapse
Affiliation(s)
- Anna Lehman
- Department of Medical Genetics and Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
SUZUKI Y. Emerging novel concept of chaperone therapies for protein misfolding diseases. PROCEEDINGS OF THE JAPAN ACADEMY. SERIES B, PHYSICAL AND BIOLOGICAL SCIENCES 2014; 90:145-62. [PMID: 24814990 PMCID: PMC4104511 DOI: 10.2183/pjab.90.145] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/14/2014] [Indexed: 06/03/2023]
Abstract
Chaperone therapy is a newly developed molecular therapeutic approach to protein misfolding diseases. Among them we found unstable mutant enzyme proteins in a few lysosomal diseases, resulting in rapid intracellular degradation and loss of function. Active-site binding low molecular competitive inhibitors (chemical chaperones) paradoxically stabilized and enhanced the enzyme activity in somatic cells by correction of the misfolding of enzyme protein. They reached the brain through the blood-brain barrier after oral administration, and corrected pathophysiology of the disease. In addition to these inhibitory chaperones, non-competitive chaperones without inhibitory bioactivity are being developed. Furthermore molecular chaperone therapy utilizing the heat shock protein and other chaperone proteins induced by small molecules has been experimentally tried to handle abnormally accumulated proteins as a new approach particularly to neurodegenerative diseases. These three types of chaperones are promising candidates for various types of diseases, genetic or non-genetic, and neurological or non-neurological, in addition to lysosomal diseases.
Collapse
Affiliation(s)
- Yoshiyuki SUZUKI
- Special Visiting Scientist, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
| |
Collapse
|