Division of Gene Therapy, Research Center for Medical Sciences, Department of Pediatrics, The Jikei University School of Medicine, Tokyo, 105-8461, Japan.
J Hum Genet. 2019 Feb;64(2):127-137. doi: 10.1038/s10038-018-0534-8. Epub 2018 Nov 19.
Mucopolysaccharidosis (MPS) is a group of inherited conditions involving metabolic dysfunction. Lysosomal enzyme deficiency leads to the accumulation of glycosaminoglycan (GAG) resulting in systemic symptoms, and is categorized into seven types caused by deficiency in one of eleven different enzymes. The pathophysiological mechanism of these diseases has been investigated, indicating impaired autophagy in neuronal damage initiation, association of activated microglia and astrocytes with the neuroinflammatory processes, and involvement of tauopathy. A new inherited error of metabolism resulting in a multisystem disorder with features of the MPS was also identified. Additionally, new therapeutic methods are being developed that could improve conventional therapies, such as new recombinant enzymes that can penetrate the blood brain barrier, hematopoietic stem cell transplantation with reduced intensity conditioning, gene therapy using a viral vector system or gene editing, and substrate reduction therapy. In this review, we discuss the recent developments in MPS research and provide a framework for developing strategies.
黏多糖贮积症(MPS)是一组涉及代谢功能障碍的遗传疾病。溶酶体酶缺乏导致糖胺聚糖(GAG)的积累,从而导致全身症状,并分为由十一种不同酶中的一种缺乏引起的七种类型。这些疾病的病理生理机制已被研究,表明在神经元损伤起始时自噬受损,激活的小胶质细胞和星形胶质细胞与神经炎症过程相关,以及tau 病的参与。也发现了一种新的遗传性代谢错误,导致具有 MPS 特征的多系统疾病。此外,正在开发新的治疗方法,以改善传统疗法,例如可以穿透血脑屏障的新型重组酶、强度降低调理的造血干细胞移植、使用病毒载体系统或基因编辑的基因治疗,以及底物减少疗法。在这篇综述中,我们讨论了 MPS 研究的最新进展,并为制定策略提供了框架。