Annunziata Ida, d'Azzo Alessandra
Department of Genetics, St. Jude Children's Research Hospital, Memphis, TN, USA.
Expert Opin Orphan Drugs. 2017;5(2):131-141. doi: 10.1080/21678707.2016.1266933. Epub 2016 Dec 14.
Galactosialidosis is a glycoprotein storage disease caused by mutations in the gene, encoding lysosomal protective protein/cathepsin A (PPCA). The enzyme's catalytic activity is distinct from its protective function towards β-galactosidase (β-GAL) and neuraminidase 1 (NEU1), with which PPCA forms a complex. In this configuration the two glycosidases acquire their full activity and stability in lysosomes. Deficiency of PPCA results in combined NEU1/β-GAL deficiency. Because of its low incidence, galactosialidosis is considered an orphan disorder with no therapy yet available.
This review gives a historic overview on the discovery of PPCA, which defined galactosialidosis as a new clinical entity; the evidence for the existence of the PPCA/NEU1/β-GAL complex; the clinical forms of galactosialidosis and disease-causing mutations. mice have proven to be a suitable model to test different therapeutic approaches, paving the way for the development of clinical trials for patients with galactosialidosis.
Improved understanding of the molecular bases of disease has sparked renewed incentive from clinicians and scientists alike to develop therapies for rare conditions, like GS, and has increased the willingness of biotech companies to invest in the manufacturing of new therapeutics. Both ERT and gene therapy may become available to patients in the near future.
半乳糖唾液酸贮积症是一种糖蛋白贮积病,由编码溶酶体保护蛋白/组织蛋白酶A(PPCA)的基因突变引起。该酶的催化活性与其对β-半乳糖苷酶(β-GAL)和神经氨酸酶1(NEU1)的保护功能不同,PPCA与它们形成复合物。在这种结构中,这两种糖苷酶在溶酶体中获得其全部活性和稳定性。PPCA缺乏导致NEU1/β-GAL联合缺乏。由于其发病率低,半乳糖唾液酸贮积症被认为是一种罕见病,目前尚无治疗方法。
本综述对PPCA的发现进行了历史概述,PPCA的发现将半乳糖唾液酸贮积症定义为一种新的临床实体;PPCA/NEU1/β-GAL复合物存在的证据;半乳糖唾液酸贮积症的临床形式和致病突变。小鼠已被证明是测试不同治疗方法的合适模型,为半乳糖唾液酸贮积症患者的临床试验开发铺平了道路。
对疾病分子基础的深入理解激发了临床医生和科学家为罕见病(如半乳糖唾液酸贮积症)开发治疗方法的新动力,并增加了生物技术公司投资生产新疗法的意愿。在不久的将来,酶替代疗法(ERT)和基因疗法可能都可供患者使用。