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Fischetto R, Palladino V, Mancardi MM, Giacomini T, Palladino S, Gaeta A, Di Rocco M, Zampini L, Lassandro G, Favia V, Tripaldi ME, Strisciuglio P, Romano A, Severino M, Morrone A, Giordano P. Substrate reduction therapy with Miglustat in pediatric patients with GM1 type 2 gangliosidosis delays neurological involvement: A multicenter experience. Mol Genet Genomic Med 2020; 8:e1371. [PMID: 32779865 PMCID: PMC7549581 DOI: 10.1002/mgg3.1371] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/30/2020] [Accepted: 06/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In GM1 gangliosidosis the lack of function of β-galactosidase results in an accumulation of GM1 ganglioside and related glycoconjugates in visceral organs, and particularly in the central nervous system, leading to severe disability and premature death. In the type 2 form of the disease, early intervention would be important to avoid precocious complications. To date, there are no effective therapeutic options in preventing progressive neurological deterioration. Substrate reduction therapy with Miglustat, a N-alkylated sugar that inhibits the enzyme glucosylceramide synthase, has been proposed for the treatment of several lysosomal storage disorders such as Gaucher type 1 and Niemann Pick Type C diseases. However, data on Miglustat therapy in patients with GM1 gangliosidosis are still scarce. METHODS We report here the results of Miglustat administration in four Italian children (average age: 55 months, range 20-125) affected by GM1 gangliosidosis type 2 treated in three different Italian pediatric hospitals specialized in metabolic diseases. CONCLUSION This treatment was safe and relatively well tolerated by all patients, with stabilization and/or slowing down of the neurological progression in three subjects.
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Affiliation(s)
- Rita Fischetto
- Clinical Genetics Unit, Department of Pediatric Medicine, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Valentina Palladino
- Department of Biomedical Science and Human Oncology, Pediatric Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Maria M Mancardi
- Unit of Child Neuropsychiatry, Clinical and Surgical Neurosciences Department, IRCCS Institute Giannina Gaslini, Genoa, Italy
| | - Thea Giacomini
- Unit of Child Neuropsychiatry, Clinical and Surgical Neurosciences Department, IRCCS Institute Giannina Gaslini, Genoa, Italy
| | | | - Alberto Gaeta
- Radiology Unit, Pediatric Hospital Giovanni XXIII, Bari, Italy
| | - Maja Di Rocco
- Unit of Rare Diseases, IRCCS Institute Giannina Gaslini, Genoa, Italy
| | - Lucia Zampini
- Department of Clinical Sciences, Division of Pediatrics, Polytechnic University of Marche, OspedaliRiuniti, Presidio Salesi, Ancona, Italy
| | - Giuseppe Lassandro
- Department of Biomedical Science and Human Oncology, Pediatric Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Vito Favia
- Clinical Genetics Unit, Department of Pediatric Medicine, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Maria E Tripaldi
- Department of Biomedical Science and Human Oncology, Pediatric Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Pietro Strisciuglio
- Department of Medical Translational Sciences Section of Pediatrics, University Federico II Naples, Napoli, Italy
| | - Alfonso Romano
- Department of Medical Translational Sciences Section of Pediatrics, University Federico II Naples, Napoli, Italy
| | | | - Amelia Morrone
- Paediatric Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital, Florence, Italy
| | - Paola Giordano
- Department of Biomedical Science and Human Oncology, Pediatric Unit, University of Bari "Aldo Moro", Bari, Italy
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Fischetto R, Palmieri VV, Tripaldi ME, Gaeta A, Michelucci A, Delvecchio M, Francavilla R, Giordano P. Alagille Syndrome: A Novel Mutation in JAG1 Gene. Front Pediatr 2019; 7:199. [PMID: 31157196 PMCID: PMC6529843 DOI: 10.3389/fped.2019.00199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/30/2019] [Indexed: 11/18/2022] Open
Abstract
Alagille syndrome is an autosomal dominant multisystem disorder with variable phenotypic penetrance, caused by heterozygous mutations in JAG1 or NOTCH2, encoding for the components of the Notch signaling pathway. In this paper, we described a novel mutation not yet reported in literature. This 3-years old male child was referred to our Clinical Genetics Unit because of delayed psychomotor development, systolic murmur, dysmorphic facial features, and hypertransaminasemia. The novel JAG1 heterozygous c.2026delT variant in exon 16 was found. JAG1 mutations are classified as protein truncating and non-protein truncating, without any genotype-phenotype correlation. The detected mutation determines a stop codon (p.Cys676AlafsTer67) in the gene sequence, encoding a truncated protein. Our report broadens the spectrum of JAG1 gene mutations.
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Affiliation(s)
- Rita Fischetto
- Clinical Genetics Unit, Department of Paediatric Medicine, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Viviana V Palmieri
- Pediatric Section, Department of Biomedicine and Human Oncology, University A. Moro, Bari, Italy
| | - Maria E Tripaldi
- Pediatric Section, Department of Biomedicine and Human Oncology, University A. Moro, Bari, Italy
| | - Alberto Gaeta
- PediatricRadiology Unit, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Angela Michelucci
- Laboratory of Molecular Genetics, University Hospital of Pisa, Pisa, Italy
| | | | - Ruggiero Francavilla
- Pediatric Section, Department of Biomedicine and Human Oncology, University A. Moro, Bari, Italy
| | - Paola Giordano
- Pediatric Section, Department of Biomedicine and Human Oncology, University A. Moro, Bari, Italy
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