Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy.
Oncohematology and BMT Unit, Mediterranean Institute of Oncology, Viagrande, Italy.
Orphanet J Rare Dis. 2023 Feb 13;18(1):27. doi: 10.1186/s13023-023-02623-7.
Gaucher disease (GD) is a rare, inherited, autosomal recessive disorder caused by a deficiency of the lysosomal enzyme, acid β-glucosidase. Its diagnosis is achieved via measurements of acid β-glucosidase activity in either fresh peripheral blood leukocytes or dried blood spots, and confirmed by identifying characteristic mutations in the GBA1 gene. Currently, several biomarkers are available for disease monitoring. Chitotriosidase has been used over the last 20 years to assess the severity of GD, but lacks specificity in GD patients. Conversely, the deacylated form of glucosylceramide, glucosylsphingosine (also known as lyso-Gb1), represents a more reliable biomarker characterized by its high sensitivity and specificity in GD.
Herein, we review the current literature on lyso-Gb1 and describe evidence supporting its usefulness as a biomarker for diagnosing and evaluating disease severity in GD and monitoring treatment efficacy.
Lyso-Gb1 is the most promising biomarker of GD, as demonstrated by its reliability in reflecting disease burden and monitoring treatment response. Furthermore, lyso-Gb1 may play an important role in the onset of monoclonal gammopathy of uncertain significance, multiple myeloma, and Parkinson's disease in GD patients.
戈谢病(GD)是一种罕见的、遗传性的、常染色体隐性疾病,由溶酶体酶酸性β-葡萄糖苷酶的缺乏引起。其诊断通过测量新鲜外周血白细胞或干血斑中的酸性β-葡萄糖苷酶活性来实现,并通过鉴定 GBA1 基因中的特征突变来确认。目前,有几种生物标志物可用于疾病监测。壳三糖苷酶在过去 20 年中一直用于评估 GD 的严重程度,但在 GD 患者中缺乏特异性。相反,脱酰基形式的葡糖基神经酰胺,葡糖基神经鞘氨醇(也称为溶酶体-Gb1),是一种更可靠的生物标志物,其在 GD 中的灵敏度和特异性都很高。
本文综述了关于溶酶体-Gb1 的现有文献,并描述了支持其作为诊断 GD 以及评估疾病严重程度和监测治疗效果的生物标志物的有用性的证据。
溶酶体-Gb1 是 GD 最有前途的生物标志物,其在反映疾病负担和监测治疗反应方面的可靠性得到了证明。此外,溶酶体-Gb1 可能在 GD 患者中发生意义未明的单克隆丙种球蛋白病、多发性骨髓瘤和帕金森病中发挥重要作用。