Myrl Holida, Aleš Linhart, Antonio Pisani, Nicola Longo, François Eyskens, Ozlem Goker-Alpan, Eric Wallace, Patrick Deegan, Camilla Tøndel, Ulla Feldt-Rasmussen, Derralynn Hughes, Anat Sakov, Rossana Rocco, Einat Brill Almon, Sari Alon, Raul Chertkoff, David G Warnock, Stephen Waldek, William R Wilcox, John A Bernat
{"title":"A phase III, open-label clinical trial evaluating pegunigalsidase alfa administered every 4 weeks in adults with Fabry disease previously treated with other enzyme replacement therapies.","authors":"Myrl Holida, Aleš Linhart, Antonio Pisani, Nicola Longo, François Eyskens, Ozlem Goker-Alpan, Eric Wallace, Patrick Deegan, Camilla Tøndel, Ulla Feldt-Rasmussen, Derralynn Hughes, Anat Sakov, Rossana Rocco, Einat Brill Almon, Sari Alon, Raul Chertkoff, David G Warnock, Stephen Waldek, William R Wilcox, John A Bernat","doi":"10.1002/jimd.12795","DOIUrl":"https://doi.org/10.1002/jimd.12795","url":null,"abstract":"<p><p>Pegunigalsidase alfa, a PEGylated α-galactosidase A enzyme replacement therapy (ERT) for Fabry disease, has a longer plasma half-life than other ERTs administered intravenously every 2 weeks (E2W). BRIGHT (NCT03180840) was a phase III, open-label study in adults with Fabry disease, previously treated with agalsidase alfa or beta E2W for ≥3 years, who switched to 2 mg/kg pegunigalsidase alfa every 4 weeks (E4W) for 52 weeks. Primary objective assessed safety, including number of treatment-emergent adverse events (TEAEs). Thirty patients were enrolled (24 males); 23 previously received agalsidase beta. Pegunigalsidase alfa plasma concentrations remained above the lower limit of quantification throughout the 4-week dosing interval. Thirty-three of 182 TEAEs (in 9 patients) were considered treatment-related; all were mild/moderate. No patients developed de novo anti-drug antibodies (ADAs). In the efficacy analysis (n = 29), median (inter-quartile range) eGFR change from baseline over 52 weeks was -1.9 (-5.9; 1.8) mL/min/1.73 m<sup>2</sup> (n = 28; males [n = 22]: -2.4 [-5.2; 3.2]; females [n = 6]: -0.7 [-9.2; 2.0]). Overall, median eGFR slope was -1.9 (-8.3; 1.9) mL/min/1.73 m<sup>2</sup>/year (ADA-negative [n = 20]: -1.2 [-6.4; 2.6]; ADA-positive [n = 9]: -8.4 [-11.6; -1.0]). Lyso-Gb3 concentrations were low and stable in females, with a slight increase in males (9/24 ADA-positive). The BRIGHT study results suggest that 2 mg/kg pegunigalsidase alfa E4W is tolerated well in stable adult patients with Fabry disease. Due to the low number of patients in this study, more research is needed to demonstrate the effects of pegunigalsidase alfa given E4W. Further evidence, outside of this clinical trial, should be factored in for physicians to prolong the biweekly ERT intervals to E4W. TAKE-HOME MESSAGE: Treatment with 2 mg/kg pegunigalsidase alfa every 4 weeks could offer a new treatment option for patients with Fabry disease.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetically humanized phenylketonuria mouse model as a testing tool for human genome editing in fertilized eggs.","authors":"Atsumi Tsuji-Hosokawa, Iku Tsuchiya, Kie Shimizu, Miho Terao, Mito Yasuhara, Natsuho Miyamoto, Saki Kikuchi, Yuya Ogawa, Kazuaki Nakamura, Yoichi Matsubara, Shuji Takada","doi":"10.1002/jimd.12803","DOIUrl":"https://doi.org/10.1002/jimd.12803","url":null,"abstract":"<p><p>Targeted genome editing has made significant advancements; however, safety and ethical issues have not been fully elucidated, resulting in strict control of the technique. We tested genome editing tools on gametes from a genetically humanized mouse model using a phenylketonuria (PKU) mouse model to gain insights into genome editing in human embryos. The human PKU mouse model Pah<sup>hR111X</sup> mice was generated. The junctional region between exon 3 and intron 3 of Pah was replaced with a 120 bp corresponding human PAH sequence, including the pathogenic common variant c.331C > T in Pah<sup>hR111X</sup> mice. Pah<sup>hR111X</sup> mice successfully recapitulated the PKU phenotype and showed cognitive dysfunction and depressive-like behavior, which are observed in human patients with PKU. Genome editing was applied to fertilized eggs of Pah<sup>hR111X</sup> mice utilizing sgRNA that targets the human sequence. Mice with the corrected allele exhibited normal serum phenylalanine levels. Through genome editing, we validated the utility of sgRNA. The genetically humanized mouse model suggested that germ-line genome editing of the pathogenic variant may be feasible for monogenic disorders by revealing the recovery of the phenotype; however, there are remaining issues with the tool, including its efficiency and accuracy. This genome editing protocol using a genetically humanized mouse model will provide insights for improving current issues and contribute to the establishment of heritable human genome editing protocols.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Rock, Oded Rock, Suha Daas, Vered Biton-Regev, Nadav Sagiv, Nasser Abu Salah, Yair Anikster, Ortal Barel, Ronen Hady Cohen, Elena Dumin, Aviva Fattal-Valevski, Tzipora Falik-Zaccai, Eli Herskovitz, Sagi Josefsberg, Hatem Khammash, Katya Kneller, Stanley H Korman, Yuval E Landau, Tally Lerman-Sagie, Hanna Mandel, Elon Pras, Haike Reznik-Wolf, Avraham Shaag, Nava Shaul Lotan, Ronen Spiegel, Galit Tal, Orna Staretz-Chacham, Yael Wilnai, Shlomo Almashanu
{"title":"Newborn screening algorithm distinguishing potential symptomatic isovaleric acidemia from asymptomatic newborns.","authors":"Rachel Rock, Oded Rock, Suha Daas, Vered Biton-Regev, Nadav Sagiv, Nasser Abu Salah, Yair Anikster, Ortal Barel, Ronen Hady Cohen, Elena Dumin, Aviva Fattal-Valevski, Tzipora Falik-Zaccai, Eli Herskovitz, Sagi Josefsberg, Hatem Khammash, Katya Kneller, Stanley H Korman, Yuval E Landau, Tally Lerman-Sagie, Hanna Mandel, Elon Pras, Haike Reznik-Wolf, Avraham Shaag, Nava Shaul Lotan, Ronen Spiegel, Galit Tal, Orna Staretz-Chacham, Yael Wilnai, Shlomo Almashanu","doi":"10.1002/jimd.12800","DOIUrl":"https://doi.org/10.1002/jimd.12800","url":null,"abstract":"<p><p>Newborn screening (NBS) for isovaleric acidemia (IVA) reduces mortality and morbidity; however, it has also resulted in the detection of individuals with an asymptomatic or mild presentation for which early detection via newborn screening has not been proven to alter neurological outcome. We reevaluated biochemical and molecular data for newborns flagged positive for IVA in aim of developing a new screening algorithm to exclude the latter from positive screening. Among 2 794 365 newborns underwent routine newborn screening in Israel, 412 flagged positive for IVA, of which, 371 were false positives on recall sample testing and 41 positive newborns were referred to the clinic. 38/41 have biochemical and molecular confirmation in keeping with IVA. Among the 38 patients, 32% (12/38) were classified as symptomatic while, 68% (26/38) were classified as asymptomatic. 69% of the latter group harbor the known variant associated with mild potentially asymptomatic phenotype, c.932C>T; p. Ala311Val. Among asymptomatic patients, only 46% (12/26) are currently treated. Two novel variants have been detected in the IVD gene: c.487G>A; p. Ala163Thr and c.985A>G; p. Met329Val. Cut-off recalculation, of referred newborns' initial biochemical results, after classifying the referred patients to two binary groups of symptomatic and asymptomatic, resulted in an improved NBS algorithm comprising of C5 >5 μM and C5/C2>0.2 and C5/C3>4 flagging only those likely to have the classic symptomatic phenotype.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"“East meets West”: SSIEM 2023 Annual Symposium at Jerusalem","authors":"Yair Anikster","doi":"10.1002/jimd.12797","DOIUrl":"https://doi.org/10.1002/jimd.12797","url":null,"abstract":"<p>The 2023 Annual Symposium of the Society for the Study of Inborn Errors of Metabolism (SSIEM) was held in Jerusalem from August 29 to September 1, under the theme “East Meets West.” This gathering was a significant effort to bring together specialists from both Eastern and Western medical traditions, all united by a common goal: to enhance patient care globally by sharing knowledge, experiences, and practices in the field of inborn errors of metabolism (IEM). The symposium hosted more than 1500 participants from 64 different countries, offering a platform where experts could discuss and compare the challenges and innovations faced in different regions, whether they are in the East or the West. By transcending geographical boundaries, this event sought to create a more unified and effective approach to treating IEMs, ensuring that advances in one part of the world could benefit patients everywhere.</p><p>The plenary sessions at SSIEM 2023 reflected this commitment to global collaboration. In the session titled “Where East Meets West – Differential Expression of the Same Disease in Different Regions of the World,” participants explored how the manifestation of certain IEMs varies significantly across regions. Discussions included the higher prevalence of Neuronopathic Gaucher Disease in Eastern populations as opposed to the non-neuronopathic phenotype in the West,<span><sup>1</sup></span> the distinct phenotypes of dihydrolipoamide dehydrogenase deficiency in two Israeli populations,<span><sup>2</sup></span> and Citrin deficiency, which is common in the East but rare in the West.<span><sup>3</sup></span> Citrin deficiency in the far east was also the topic of the SSIEM annual Garrod lecture. These case studies highlighted the importance of understanding regional genetic variations to improve diagnosis and treatment strategies.</p><p>Another session, “The State of the Mitochondria – Old Players, New Roles,” focused on mitochondrial diseases, revealing how new disorders involving inborn errors of vitamins B<sub>3</sub> and B<sub>5</sub><span><sup>4</sup></span> are reshaping our understanding of mitochondrial function. The session underscored the critical role mitochondria play in various IEMs and how emerging research is uncovering new therapeutic targets.</p><p>In “Learning from the Neighbors,” the emphasis was on cross-disciplinary learning within the medical community. The session brought to light how pediatricians can learn from adult IEM cases,<span><sup>5</sup></span> the vital role laboratory scientists play in advancing clinical care, and the integration of big data and machine learning in clinical decision-making. This exchange of knowledge among different medical disciplines is crucial for refining the art of metabolomics and enhancing patient outcomes.</p><p>The session on “The Complexity of Brain Traffic: New Insights from Neurometabolism” provided new perspectives on neurometabolic disorders. Discussions included inborn errors of cel","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jimd.12797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142234941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joseph Muenzer, Barbara K. Burton, Paul Harmatz, Luis González Gutiérrez‐Solana, Matilde Ruiz‐Garcia, Simon A. Jones, Nathalie Guffon, Michal Inbar‐Feigenberg, Drago Bratkovic, Stewart Rust, Michael Hale, Yuna Wu, Karen S. Yee, David A. H. Whiteman, David Alexanderian
{"title":"Evaluation of early treatment with intravenous idursulfase and intrathecal idursulfase‐IT on cognitive function in siblings with neuronopathic mucopolysaccharidosis II","authors":"Joseph Muenzer, Barbara K. Burton, Paul Harmatz, Luis González Gutiérrez‐Solana, Matilde Ruiz‐Garcia, Simon A. Jones, Nathalie Guffon, Michal Inbar‐Feigenberg, Drago Bratkovic, Stewart Rust, Michael Hale, Yuna Wu, Karen S. Yee, David A. H. Whiteman, David Alexanderian","doi":"10.1002/jimd.12790","DOIUrl":"https://doi.org/10.1002/jimd.12790","url":null,"abstract":"Mucopolysaccharidosis II (MPS II; Hunter syndrome; OMIM 309900) is a rare, X‐linked, heterogeneous lysosomal storage disease. Approximately two‐thirds of patients develop cognitive impairment, which is difficult to assess in clinical trials, partly owing to the variable nature of cognitive impairment. Analyzing data from siblings can help to minimize this heterogeneity. We report analyses of cognitive function from siblings with MPS II enrolled in clinical trials: a natural history study (NCT01822184), a randomized, open‐label, phase 2/3 study of intravenous (IV) idursulfase with or without intrathecal idursulfase (idursulfase‐IT; NCT02055118), and its extension (NCT2412787). Cognitive function was assessed using Differential Abilities Scales, Second Edition General Conceptual Ability (DAS‐II GCA) scores; Bayley Scales of Infant and Toddler Development, Third Edition; and Vineland Adaptive Behavior Scales, Second Edition Adaptive Behavior Composite (VABS‐II ABC). Seven sets of siblings (six pairs and one set of three) were included. All patients received IV idursulfase and 10 received subsequent idursulfase‐IT. Younger siblings initiated IV idursulfase at an earlier age than their older sibling(s) in six of the sets; the younger sibling started treatment before 1 year of age in three sets. Monthly idursulfase‐IT was generally associated with a stabilization of cognitive function: DAS‐II GCA and VABS‐II ABC scores were higher at age‐matched assessments in the majority of those who either received idursulfase‐IT earlier than their sibling or who received idursulfase‐IT versus no idursulfase‐IT. These data suggest that early initiation of intrathecal enzyme replacement therapy may stabilize or slow cognitive decline in some patients with neuronopathic MPS II.","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
François Feillet, Jean-Baptiste Arnoux, María Bueno Delgado, Alberto Burlina, Brigitte Chabrol, Ece Kucuksayrac, Florian B Lagler, Ania C Muntau, David Olsson, Sabrina Paci, Frank Rutsch, Francjan J van Spronsen
{"title":"Long-term safety of sapropterin in paediatric and adult individuals with phenylalanine hydroxylase deficiency: Final results of the Kuvan® Adult Maternal Paediatric European Registry multinational observational study.","authors":"François Feillet, Jean-Baptiste Arnoux, María Bueno Delgado, Alberto Burlina, Brigitte Chabrol, Ece Kucuksayrac, Florian B Lagler, Ania C Muntau, David Olsson, Sabrina Paci, Frank Rutsch, Francjan J van Spronsen","doi":"10.1002/jimd.12796","DOIUrl":"https://doi.org/10.1002/jimd.12796","url":null,"abstract":"<p><p>Phenylketonuria is a rare inherited disorder that disrupts the metabolism of phenylalanine (Phe) to tyrosine by phenylalanine hydroxylase (PAH). Sapropterin dihydrochloride (Kuvan®) is approved for use in Europe to reduce blood Phe levels and improve Phe tolerance in sapropterin-responsive individuals. KAMPER (NCT01016392) is an observational, multinational registry assessing long-term safety and efficacy of sapropterin. Five hundred and seventy-six participants with PAH deficiency were enrolled from nine European countries (69 sites; December 2009-May 2016). Participants were aged <4 years (n = 11), 4 to <12 years (n = 329), 12 to <18 years (n = 141), and ≥18 years (n = 95) at enrolment. Overall, 401 (69.6%) participants experienced a total of 1960 adverse events; 61 events in 42 participants were serious, and two were considered sapropterin-related by the investigator. Mean (standard deviation) actual dietary Phe intake increased from baseline across all age groups: 957 (799) mg/day to a maximum of 1959 (1121) mg/day over a total study period of 11 years. Most participants exhibited an increase in Phe tolerance while blood Phe levels remained in the target range for their age (120-360 μmol/L for <12 years; 120-600 μmol/L for ≥12 years). Most participants exhibited normal growth for height, weight, and body mass index. No additional safety concerns were identified. As an observational study, limitations include variability in routine care practices and inconsistent availability of data. Long-term sapropterin use demonstrates a favourable safety profile in real-world settings and increases Phe tolerance in participants with PAH deficiency while maintaining blood Phe levels in the target ranges.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian Urzì, Christoph Meyer, Déborah Mathis, Peter Vermathen, Jean-Marc Nuoffer
{"title":"Intra- and extracellular real-time analysis of perfused fibroblasts using an NMR bioreactor: A pilot study.","authors":"Christian Urzì, Christoph Meyer, Déborah Mathis, Peter Vermathen, Jean-Marc Nuoffer","doi":"10.1002/jimd.12794","DOIUrl":"https://doi.org/10.1002/jimd.12794","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolomic discrimination of different mitochondrial defects is challenging. We describe an NMR-based bioreactor allowing real-time intra- and extracellular metabolic investigation of perfused fibroblasts.</p><p><strong>Objectives: </strong>The objective of this study is (I) determining whether metabolic investigations of perfused fibroblasts overall and separated for intra- and extracellular contributions by real-time NMR allows for discrimination of different representative mitochondrial defects in a feasibility study and (II) gaining insight into physiological consequences of mitochondrial dysfunction in basal condition and during glycolysis inhibition.</p><p><strong>Methods: </strong>Overall, intra- and extracellular metabolomes of malate dehydrogenase 2 (MDH2), pyruvate dehydrogenase (PDH), complex I (CI) deficient fibroblasts, and control fibroblasts were investigated under standard culture conditions and under glycolysis inhibition. In addition to \"overall\" metabolite quantification, intra- and extracellular metabolic contributions were separated based on diffusion rate differences.</p><p><strong>Results and discussion: </strong>Overall metabolites: Chemometric analysis of the entire metabolome revealed good separation between control, PDH and MDH2, while CI was less well separated. However, mixed intra- and extracellular changes complicated interpretation of the cellular metabolism. Intra- and extracellular metabolites: Compartment specific chemometrics revealed possibly augmenting metabolomic separation between control and deficient cell lines under basal and inhibition condition. All mitochondrial defects exhibited upregulation of glycolytic metabolism compared to controls. Inhibition of glycolysis resulted in perturbations of other metabolic pathways such as glutaminolysis, alanine, arginine, glutamate, and proline metabolism. MDH2 showed upregulation of alanine and glutamate metabolism, while the CI defect revealed lower intracellular arginine and downregulation of glutamate and arginine-dependent proline synthesis.</p><p><strong>Conclusion: </strong>Discrimination of intra- and extracellular metabolic contributions helps understanding the underlying mechanisms of mitochondrial disorders, uncovers potential metabolic biomarkers, and unravels metabolic pathway-specific adaptations in response to metabolic perturbations.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High-risk screening for late-onset Pompe disease in China: An expanded multicenter study.","authors":"Kexin Jiao, Bochen Zhu, Xueli Chang, Junhong Guo, Jun Fu, Xueqin Song, Xuen Yu, Xiaoge Zhang, Jihong Dong, Wang Yan, Xinghua Luan, Zhiqiang Wang, Hong Han, Lijun Du, Liqiang Yu, Yali Zhang, Jingjing Zhang, Yan Chen, Jing Hu, Zhe Zhao, Juan Kang, Song Tan, Zhiyun Wang, Shanshan Mao, Fangyuan Qian, Ronghua Luo, Changxia Liu, Zhengyu Huang, Gang Li, Xia Li, Lijun Luo, Dong Li, Yuanlin Zhou, Xiafei Hu, Xuefan Yu, Yongguang Shi, Jianming Jiang, Jialong Zhang, Nachuan Cheng, Ningning Wang, Xingyu Xia, Dongyue Yue, Mingshi Gao, Jianying Xi, Sushan Luo, Jiahong Lu, Chongbo Zhao, Qing Ke, Mingming Ma, Wenhua Zhu","doi":"10.1002/jimd.12793","DOIUrl":"https://doi.org/10.1002/jimd.12793","url":null,"abstract":"<p><p>Late-onset Pompe disease (LOPD) is caused by a genetic deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA), leading to progressive limb-girdle weakness and respiratory impairment. The insidious onset of non-specific early symptoms often prohibits timely diagnosis. This study aimed to validate the high-risk screening criteria for LOPD in the Chinese population. A total of 726 patients were included, including 96 patients under 14 years of age. Dried blood spots (DBS) and tandem mass spectrometry (MS/MS) were employed to evaluate serum GAA activity. Forty-four patients exhibited a decreased GAA activity, 16 (2.2%) of which were confirmed as LOPD by genetic testing. Three previously unreported GAA mutations were also identified. The median diagnostic delay was shortened to 3 years, which excelled the previous retrospective studies. At diagnosis, most patients exhibited impaired respiratory function and/or limb-girdle weakness. Elevated serum creatine kinase (CK) levels were more frequently observed in patients who manifested before age 16. Overall, high-risk screening is a feasible and efficient method to identify LOPD patients at an early stage. Patients over 1 year of age with either weakness in axial and/or proximal limb muscles, or unexplained respiratory distress shall be subject to GAA enzymatic test, while CK levels above 2 times the upper normal limit shall be an additional criterion for patients under 16. This modified high-risk screening criteria for LOPD requires further validation in larger Chinese cohorts.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Schnabel-Besson, Sven F Garbade, Florian Gleich, Sarah C Grünert, Johannes Krämer, Eva Thimm, Julia B Hennermann, Peter Freisinger, Peter Burgard, Gwendolyn Gramer, Marina A Morath, A Tunç Tuncel, Svenja Keßler, Georg F Hoffmann, Stefan Kölker, Ulrike Mütze
{"title":"Parental and child's psychosocial and financial burden living with an inherited metabolic disease identified by newborn screening.","authors":"Elena Schnabel-Besson, Sven F Garbade, Florian Gleich, Sarah C Grünert, Johannes Krämer, Eva Thimm, Julia B Hennermann, Peter Freisinger, Peter Burgard, Gwendolyn Gramer, Marina A Morath, A Tunç Tuncel, Svenja Keßler, Georg F Hoffmann, Stefan Kölker, Ulrike Mütze","doi":"10.1002/jimd.12784","DOIUrl":"https://doi.org/10.1002/jimd.12784","url":null,"abstract":"<p><p>Newborn screening (NBS) is one of the most effective measures of secondary prevention. While the benefit of NBS on the clinical long-term outcomes of children with inherited metabolic diseases (IMD) has been demonstrated, the potential burden of families living with an early diagnosed and treated child with an IMD has not been thoroughly investigated. The aim of this longitudinal questionnaire-based study on 369 families living with a child with an IMD was to investigate the psychosocial and financial burden following a true-positive NBS. The reported psychosocial burden differed between children and their parents, and was associated with the child's age, diagnosis, and treatment. At younger ages, parent-reported burden was higher for the parents than for the individual child, while it increased for children and decreased for parents as the child grew older. Furthermore, psychosocial burden increased if the child required a strict dietary treatment and was at risk of metabolic decompensation. Regardless of diagnosis and treatment, the developmental delay of their child independently increased the parental psychosocial burden. Financial burden was reported by 24% of all families, and was higher in low-income families and in families whose children required dietary treatment. In conclusion, a substantial psychosocial and financial burden was revealed for children and their families after true-positive NBS. Since this burden is likely to have a negative impact on the long-term individual health benefits of NBS, this study underlines the importance of regularly assessing the psychosocial and financial needs of these families.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amira Abdel Moneam Adly, Eman Abdel Rahman Ismail, Fatma A Ibrahim, Mira Atef, Khaled Anwar El Sayed, Nihal Hussien Aly
{"title":"A 6-month randomized controlled trial for vitamin E supplementation in pediatric patients with Gaucher disease: Effect on oxidative stress, disease severity and hepatic complications.","authors":"Amira Abdel Moneam Adly, Eman Abdel Rahman Ismail, Fatma A Ibrahim, Mira Atef, Khaled Anwar El Sayed, Nihal Hussien Aly","doi":"10.1002/jimd.12792","DOIUrl":"https://doi.org/10.1002/jimd.12792","url":null,"abstract":"<p><p>Enzymatic deficiency in Gaucher disease (GD) may induce oxidative stress. Vitamin E is the nature's most effective lipid-soluble antioxidant. This prospective clinical trial assessed the oxidant-antioxidant status in Egyptian patients with GD and the efficacy and safety and of vitamin E as an adjuvant antioxidant therapy. Forty children and adolescents with GD on stable doses of enzyme replacement therapy (ERT) were enrolled. Abdominal ultrasonography and transient elastography were performed. Malondialdehyde (MDA), vitamin E, and antioxidant enzymes (reduced glutathione [GSH], superoxide dismutase [SOD], glutathione peroxidase [GPx], and peroxiredoxin 2 [PRDX2]) were assessed. Patients were compared with 40 age- and sex-matched healthy controls. Patients with GD were randomized either to receive oral vitamin E for 6 months or not. All patients with GD had significantly higher MDA levels with lower levels of vitamin E and antioxidant enzymes compared with healthy controls (p < 0.001). Vitamin E and PRDX2 were negatively correlated to severity score index (SSI), lyso GL1, and MDA. After 6 months of vitamin E supplementation, SSI and liver and spleen volumes and liver stiffness were significantly lower. Lyso GL1 and MDA were significantly decreased post-vitamin E therapy while antioxidant enzymes were significantly higher compared with baseline levels and with patients without vitamin E therapy. Oxidative stress is related to disease severity in pediatric patients with GD. A 6-month vitamin E supplementation for those patients represents a safe therapeutic adjuvant agent increasing the efficacy of ERT, reducing oxidative stress, and improving outcomes.</p>","PeriodicalId":16281,"journal":{"name":"Journal of Inherited Metabolic Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}