Pompe Disease: Current State and Future Treatments.

Abstract

Pompe disease is an autosomal recessive genetic disease caused by a mutation in the acid α-glucosidase (GAA) gene, which results in dysfunction of the GAA and a buildup of glycogen in lysosomes. Recently, new research has found additional causes of the disease pathology, such as the role of autophagy. Currently, the standard of care is enzyme replacement therapy (ERT). ERT has been proven to increase survival in Pompe disease as well as improve pulmonary and motor tests compared to no treatment. However, some patients do not see improvement from these treatments, and the life expectancy and quality of life of patients with Pompe disease remain low. New research focuses on gene therapy with an adeno-associated virus-mediated α-glucosidase vector (rAAV1-hGAA or rAAV1-CMV-hGAA). Gene therapy has the potential to provide longer-term treatment for patients with Pompe disease. Patients commonly experience side effects from the procedure such as pneumothorax, capnothorax, pericardial effusion, pleural effusion, lung contusion, etc. In phase I/II trials, the gene therapy has been found to be safe, result in sustained GAA levels, and have some improvements in pulmonary function. Many clinical trials are currently ongoing.