[Genetic disorders of N-acetylneuraminic acid metabolism: sialurias and sialidoses].

Sialuria and sialidosis represent the two known types of genetic errors of sialic acid metabolism. Sialuria type I (or "massive Sialuria") remains a very rare disease, characterized by the daily excretion of 10 g of N-acetylneuraminic acid. Although the primary defect has not been established, the absence of a feedback inhibition of the anabolic reactions is probably involved in the massive production of free sialic acid. Sialuria type II (Salla disease) and type III are lysosomal storage diseases and the patients have shown to have a 10 to 15 fold increase in the amount of free sialic acid in urine. These sialurias probably involve a defect in translocation of sialic acid from lysosomes to the site of biosynthesis. The sialidase deficiency has been found to be responsible of a number of storage diseases previously unclassified or described as "lipomucopolysaccharidosis" or "mucolipidosis I". The sialidase deficiency, or Sialidosis, is characterized by and increased urinary excretion of sialyloligosaccharides and storage of sialylated compounds. A third type of genetic error, the combined beta-galactosidase-sialidase deficiency, is due to the genetic deficiency of a 32 KD "protective protein" which is part of the complex formed between multimeric beta-galactosidase and sialidase.