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Beckmann N, Becker KA, Kadow S, Schumacher F, Kramer M, Kühn C, Schulz-Schaeffer WJ, Edwards MJ, Kleuser B, Gulbins E, Carpinteiro A. Acid Sphingomyelinase Deficiency Ameliorates Farber Disease. Int J Mol Sci 2019; 20:ijms20246253. [PMID: 31835809 PMCID: PMC6941101 DOI: 10.3390/ijms20246253] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/03/2019] [Accepted: 12/07/2019] [Indexed: 12/20/2022] Open
Abstract
Farber disease is a rare lysosomal storage disorder resulting from acid ceramidase deficiency and subsequent ceramide accumulation. No treatments for Farber disease are clinically available, and affected patients have a severely shortened lifespan. We have recently reported a novel acid ceramidase deficiency model that mirrors the human disease closely. Acid sphingomyelinase is the enzyme that generates ceramide upstream of acid ceramidase in the lysosomes. Using our acid ceramidase deficiency model, we tested if acid sphingomyelinase could be a potential novel therapeutic target for the treatment of Farber disease. A number of functional acid sphingomyelinase inhibitors are clinically available and have been used for decades to treat major depression. Using these as a therapeutic for Farber disease, thus, has the potential to improve central nervous symptoms of the disease as well, something all other treatment options for Farber disease can’t achieve so far. As a proof-of-concept study, we first cross-bred acid ceramidase deficient mice with acid sphingomyelinase deficient mice in order to prevent ceramide accumulation. Double-deficient mice had reduced ceramide accumulation, fewer disease manifestations, and prolonged survival. We next targeted acid sphingomyelinase pharmacologically, to test if these findings would translate to a setting with clinical applicability. Surprisingly, the treatment of acid ceramidase deficient mice with the acid sphingomyelinase inhibitor amitriptyline was toxic to acid ceramidase deficient mice and killed them within a few days of treatment. In conclusion, our study provides the first proof-of-concept that acid sphingomyelinase could be a potential new therapeutic target for Farber disease to reduce disease manifestations and prolong survival. However, we also identified previously unknown toxicity of the functional acid sphingomyelinase inhibitor amitriptyline in the context of Farber disease, strongly cautioning against the use of this substance class for Farber disease patients.
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Affiliation(s)
- Nadine Beckmann
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Katrin Anne Becker
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Stephanie Kadow
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Fabian Schumacher
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany;
| | - Melanie Kramer
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Claudine Kühn
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | | | - Michael J. Edwards
- Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45229, USA;
| | - Burkhard Kleuser
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany;
| | - Erich Gulbins
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
- Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45229, USA;
| | - Alexander Carpinteiro
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
- Department of Hematology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
- Correspondence: ; Tel.: +49-201-723-84579; Fax: +49-201-723-5974
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Choudhary N, Wadhawan S, Singh R, Bhadoria P. Anaesthetic management of a child with Farber's lipogranulomatosis posted for exploratory laparotomy. Indian J Anaesth 2019; 63:953-955. [PMID: 31772410 PMCID: PMC6868669 DOI: 10.4103/ija.ija_418_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/08/2019] [Accepted: 08/19/2019] [Indexed: 11/04/2022] Open
Affiliation(s)
- Nitin Choudhary
- Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India
| | - Sonia Wadhawan
- Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India
| | - Rahil Singh
- Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India
| | - Poonam Bhadoria
- Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India
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Yu FPS, Sajdak BS, Sikora J, Salmon AE, Nagree MS, Gurka J, Kassem IS, Lipinski DM, Carroll J, Medin JA. Acid Ceramidase Deficiency in Mice Leads to Severe Ocular Pathology and Visual Impairment. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 189:320-338. [PMID: 30472209 DOI: 10.1016/j.ajpath.2018.10.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 01/09/2023]
Abstract
Farber disease (FD) is a debilitating lysosomal storage disorder characterized by severe inflammation and neurodegeneration. FD is caused by mutations in the ASAH1 gene, resulting in deficient acid ceramidase (ACDase) activity. Patients with ACDase deficiency exhibit a broad clinical spectrum. In classic cases, patients develop hepatosplenomegaly, nervous system involvement, and childhood mortality. Ocular manifestations include decreased vision, a grayish appearance to the retina with a cherry red spot, and nystagmus. That said, the full effect of ACDase deficiency on the visual system has not been studied in detail. We previously developed a mouse model that is orthologous for a known patient mutation in Asah1 that recapitulates human FD. Herein, we report evidence of a severe ocular pathology in Asah1P361R/P361R mice. Asah1P361R/P361R mice exhibit progressive retinal and optic nerve pathology. Through noninvasive ocular imaging and histopathological analyses of these Asah1P361R/P361R animals, we revealed progressive inflammation, the presence of retinal dysplasia, and significant storage pathology in various cell types in both the retina and optic nerves. Lipidomic analyses of retinal tissues revealed an abnormal accumulation of ceramides and other sphingolipids. Electroretinograms and behavioral tests showed decreased retinal and visual responses. Taken together, these data suggest that ACDase deficiency leads to sphingolipid imbalance, inflammation, dysmorphic retinal and optic nerve pathology, and severe visual impairment.
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Affiliation(s)
- Fabian P S Yu
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Benjamin S Sajdak
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jakub Sikora
- Rare Diseases Research Unit, Department of Pediatrics and Adolescent Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; Institute of Pathology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexander E Salmon
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Murtaza S Nagree
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Jiří Gurka
- Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Iris S Kassem
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniel M Lipinski
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin; Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, United Kingdom
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jeffrey A Medin
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Department of Biochemistry, Medical College of Wisconsin, Milwaukee, Wisconsin; University Health Network, Toronto, Ontario, Canada.
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Yu FPS, Amintas S, Levade T, Medin JA. Acid ceramidase deficiency: Farber disease and SMA-PME. Orphanet J Rare Dis 2018; 13:121. [PMID: 30029679 PMCID: PMC6053731 DOI: 10.1186/s13023-018-0845-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/14/2018] [Indexed: 12/29/2022] Open
Abstract
Acid ceramidase (ACDase) deficiency is a spectrum of disorders that includes a rare lysosomal storage disorder called Farber disease (FD) and a rare epileptic disorder called spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME). Both disorders are caused by mutations in the ASAH1 gene that encodes the lysosomal hydrolase that breaks down the bioactive lipid ceramide. To date, there have been fewer than 200 reported cases of FD and SMA-PME in the literature. Typical textbook manifestations of classical FD include the formation of subcutaneous nodules, accumulation of joint contractures, and development of a hoarse voice. In reality, however, the clinical presentation is much broader. Patients may develop severe pathologies leading to death in infancy or may develop attenuated forms of the disorder wherein they are often misdiagnosed or not diagnosed until adulthood. A clinical variability also exists for SMA-PME, in which patients develop progressive muscle weakness and seizures. Currently, there is no known cure for FD or for SMA-PME. The main treatment is symptom management. In rare cases, treatment may include surgery or hematopoietic stem cell transplantation. Research using disease models has provided insights into the pathology as well as the role of ACDase in the development of these conditions. Recent studies have highlighted possible biomarkers for an effective diagnosis of ACDase deficiency. Ongoing work is being conducted to evaluate the use of recombinant human ACDase (rhACDase) for the treatment of FD. Finally, gene therapy strategies for the treatment of ACDase deficiency are actively being pursued. This review highlights the broad clinical definition and outlines key studies that have improved our understanding of inherited ACDase deficiency-related conditions.
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Affiliation(s)
- Fabian P S Yu
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Samuel Amintas
- Laboratoire de Biochimie Métabolique, Institut Fédératif de Biologie, CHU Purpan, Toulouse, France
| | - Thierry Levade
- Laboratoire de Biochimie Métabolique, Institut Fédératif de Biologie, CHU Purpan, Toulouse, France. .,INSERM UMR1037 CRCT, Université de Toulouse, Toulouse, France.
| | - Jeffrey A Medin
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada. .,Departments of Pediatrics and Biochemistry, Medical College of Wisconsin, Milwaukee, WI, USA.
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