Strazza Michelina, Luddi Alice, Carbone Marica, Rafi Mohammad A, Costantino-Ceccarini Elvira, Wenger David A
Institute of Clinical Physiology CNR, Siena, Italy.
Mol Genet Metab. 2009 May;97(1):27-34. doi: 10.1016/j.ymgme.2009.01.005. Epub 2009 Feb 12.
Krabbe disease or globoid cell leukodystrophy is an autosomal recessive disorder resulting from mutations in the galactocerebrosidase (GALC) gene. These mutations lead to deficient GALC activity, storage of substrates of the enzyme, including psychosine, death to oligodendrocytes, decreased myelination, production of globoid cells and eventually death to the individual. While most affected individuals are infants, late-onset forms are also recognized. In addition to human patients, several animal models have been well characterized, including the twitcher mouse. A spontaneously transformed progenitor cell line was isolated from an astrocyte-enriched fraction of normal mice, partially characterized and transduced with a retrovirus-containing mouse GALC cDNA to produce increased GALC activity (20-30-fold above baseline). These cells, called MAR-52, were injected into the brains of newborn affected twitcher mice. While there was only a modest increase in lifespan and body weight, there was clear evidence for the correction of the astrocytic gliosis, normal appearing oligodendrocytes and evidence for remyelination. We demonstrate that the exogenously supplied neural progenitor cells can donate GALC enzyme to oligodendrocytes in the brains of affected mice resulting in normal myelination in the area of donor cells. At this time, hematopoietic stem cell transplantation provides the best outcome in affected mice and is the only treatment available for human patients, but it does not result in a cure even when performed in asymptomatic newborns. Complete correction probably will require a combined approach to effectively treat patients with Krabbe disease. With developments in the isolation and characterization of stem cells, this approach may improve the outcome for individuals diagnosed in the future.
克拉伯病或球形细胞脑白质营养不良是一种常染色体隐性疾病,由半乳糖脑苷脂酶(GALC)基因突变引起。这些突变导致GALC活性不足,该酶的底物(包括半乳糖神经酰胺)蓄积,少突胶质细胞死亡,髓鞘形成减少,球形细胞生成,最终个体死亡。虽然大多数受影响个体为婴儿,但迟发型病例也有报道。除人类患者外,还对多种动物模型进行了充分研究,包括震颤小鼠。从正常小鼠富含星形胶质细胞的部分分离出一种自发转化的祖细胞系,对其进行了部分特性鉴定,并用含小鼠GALC cDNA的逆转录病毒进行转导,以提高GALC活性(比基线水平高20 - 30倍)。这些细胞称为MAR - 52,被注射到新生的患震颤病小鼠脑内。虽然寿命和体重仅略有增加,但有明确证据表明星形胶质细胞增生得到纠正,少突胶质细胞外观正常,且有髓鞘再生的证据。我们证明,外源性提供的神经祖细胞可将GALC酶捐赠给患病小鼠脑内的少突胶质细胞,从而在供体细胞区域实现正常髓鞘形成。目前,造血干细胞移植在患病小鼠中效果最佳,是人类患者唯一可用的治疗方法,但即使在无症状新生儿中进行,也无法治愈。完全纠正可能需要综合方法来有效治疗克拉伯病患者。随着干细胞分离和特性鉴定技术的发展,这种方法可能会改善未来确诊患者的治疗效果。