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Should the “mitochondrial cocktail” be a default option? An opinion “线粒体鸡尾酒”应该是默认选项吗?一个意见
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-24 DOI: 10.1016/j.ymgme.2025.109264
Peter W. Stacpoole , Stephen D. Cederbaum
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引用次数: 0
Letter to the editors: Supervised machine learning prediction of genotype–phenotype correlations in PMM2-CDG, in response to Pajusalu et al. [3] 致编辑的信:PMM2-CDG基因型-表型相关性的监督式机器学习预测,回应Pajusalu等人[]。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-15 DOI: 10.1016/j.ymgme.2025.109256
Julia Boonnak
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引用次数: 0
Urinary tetraglucoside excretion as a biomarker in liver glycogen storage diseases 尿四糖苷排泄作为肝糖原储存疾病的生物标志物。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-12 DOI: 10.1016/j.ymgme.2025.109263
Ruben J. Overduin , Candelas Gross-Valle , Joost Groen , Jennifer van der Krogt , Christa A. Koops , Terry G.J. Derks , M. Rebecca Heiner-Fokkema , Andrea B. Haijer-Schreuder

Introduction

Increased urinary tetraglucoside (Glc4) excretions are associated with abnormal glycogen metabolism. While Glc4 is an established biomarker for glycogen storage disease (GSD) type II, a traditional muscle GSD, little data is available on excretions in liver GSD.

Methods

A single-center retrospective analysis was conducted on urinary Glc4 samples obtained during routine clinical care of 99 individuals with liver GSD, including 9 patients with Glc4 samples taken as part of the diagnostic work-up (i.e., before treatment) and 5 patients with Glc4 samples after liver transplantation.

Results

Glc4 excretions were increased at time of diagnosis in 1/1 GSD IIIa, 3/3 GSD IXa, 1/2 GSD IXa female carrier, 0/1 GSD IXb and 2/2 Fanconi-Bickel syndrome patients. In 8/9 of these patients with samples in the diagnostic work-up, subsequent follow-up samples were available, displaying that Glc4 excretions decreased after initiation of GSD management in 8/8 patients, and in 6/8 patients Glc4 excretions were within the reference range on last follow-up. Analysis of Glc4 samples in the monitoring phase revealed that, despite management, Glc4 excretions were elevated in the majority of GSD Ia (17/27) and Ib (6/10), and all GSD IIIa (19/19), GSD IIIb (4/4), and IXc (1/1) patients. In contrast, increased Glc4 excretions were less frequently observed in GSD IV (1/6), GSD VI (1/2), IXa (4/19), IXa female carrier (0/1), IXb (0/2), and Fanconi-Bickel syndrome (2/4) patients during clinical follow-up. After liver transplantation in a GSD Ia and a GSD Ib patient, Glc4 excretions normalized.

Conclusion

Urinary Glc4 may be a useful additional biomarker in liver GSD patients, both in the diagnostic work-up and in the monitoring phase. Future studies could additionally assess the role of Glc4 as response biomarker in drug development.
Take-home message: Urinary Glc4 may be a useful additional biomarker in liver GSD patients, both in the diagnostic work-up and in the monitoring phase.
尿四葡糖苷(Glc4)排泄增加与糖原代谢异常有关。虽然Glc4是糖原储存病(GSD) II型(一种传统的肌肉GSD)的既定生物标志物,但关于肝脏GSD排泄的数据很少。方法:对99例肝脏GSD患者在常规临床护理中采集的尿Glc4样本进行单中心回顾性分析,其中9例患者在诊断时(即治疗前)采集了Glc4样本,5例患者在肝移植后采集了Glc4样本。结果:1/1 GSD IIIa、3/3 GSD IXa、1/2 GSD IXa女性携带者、0/1 GSD IXb、2/2 Fanconi-Bickel综合征患者诊断时Glc4排泄量增高。在这些诊断检查中有样本的患者中,有8/9的患者有后续的随访样本,8/8的患者在开始GSD治疗后Glc4排泄量下降,6/8的患者在最后一次随访时Glc4排泄量在参考范围内。监测阶段的Glc4样本分析显示,尽管进行了治疗,大多数GSD Ia(17/27)和Ib(6/10)以及所有GSD IIIa(19/19)、GSD IIIb(4/4)和IXc(1/1)患者的Glc4排泄量升高。相比之下,GSD IV (1/6), GSD VI (1/2), IXa (4/19), IXa女性携带者(0/1),IXb(0/2)和Fanconi-Bickel综合征(2/4)患者在临床随访期间较少观察到Glc4排泄增加。1例GSD Ia和1例GSD Ib患者肝移植后,Glc4排泄恢复正常。结论:尿Glc4可能是肝脏GSD患者的一个有用的附加生物标志物,无论是在诊断检查还是在监测阶段。未来的研究可以进一步评估Glc4作为反应性生物标志物在药物开发中的作用。关键信息:尿Glc4可能是肝脏GSD患者的一个有用的额外生物标志物,无论是在诊断检查还是在监测阶段。
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引用次数: 0
Effectiveness of newborn screening for X-linked disorders in females: A scoping review 新生儿筛查女性x连锁疾病的有效性:一项范围综述
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-11 DOI: 10.1016/j.ymgme.2025.109262
Hanabi Geiger, Yutaka Furuta, John A. Phillips III, Rory J. Tinker

Purpose

Newborn screening (NBS) identifies thousands of infants annually with conditions amenable to early intervention. Although several X-linked (XL) conditions in NBS panels are viewed as primarily male disorders, emerging evidence shows females also present clinically. This scoping review evaluates NBS efficacy for detecting XL conditions in females.

Methods

Twelve XL genetic disorders were identified through cross-referencing the Recommended Uniform Screening Panel, American College of Medical Genetics ACT sheets, and available literature. A systematic search and scoping review identified studies reporting NBS outcomes.

Results

All twelve XL disorders reviewed affect females, often with milder phenotypes, likely due to X-inactivation. However, only 6/12 (50 %) of these conditions had relevant NBS data, and female cases were rare. Only 92/221 (42 %) of the studies included detected female cases. Skewed X-inactivation may modulate expression, leading to biomarker levels within reference ranges and reducing detection.

Conclusions

Although XL conditions affect both sexes, current NBS protocols rarely detect females or don't report sex-specific data at all. This absence highlights broader gaps in how screening outcomes are reported. Addressing these limitations may require sex-specific biomarker thresholds, alternative biomarkers, or genetic testing. Such efforts are necessary to ensure that NBS programs equitably serve all affected newborns.
目的:新生儿筛查(NBS)每年识别出数千名适合早期干预的婴儿。尽管在NBS调查中,一些x连锁(XL)疾病被认为主要是男性疾病,但新出现的证据表明,女性在临床上也存在。本综述评估了NBS检测女性XL病症的功效。方法:通过交叉参考推荐统一筛选小组、美国医学遗传学学院ACT表格和现有文献,确定12种XL遗传疾病。系统检索和范围审查确定了报告NBS结果的研究。结果:所有12种XL疾病都影响女性,通常具有较轻的表型,可能是由于x失活。然而,这些疾病中只有6/12(50%)有相关的NBS数据,女性病例很少。221项研究中只有92项(42%)纳入了已发现的女性病例。偏x失活可能会调节表达,导致生物标志物水平在参考范围内,减少检测。结论:虽然XL疾病影响两性,但目前的NBS协议很少检测到女性或根本没有报告性别特异性数据。这种缺失凸显了如何报告筛查结果的更大差距。解决这些限制可能需要性别特异性生物标志物阈值,替代生物标志物或基因检测。这样的努力是必要的,以确保国家统计局的计划公平地为所有受影响的新生儿服务。
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引用次数: 0
Novel murine model provides insights into early-onset of kidney disease in glycogen storage disease type Ib 新的小鼠模型为糖原储存病Ib型肾病的早期发病提供了见解。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-10 DOI: 10.1016/j.ymgme.2025.109258
Kunal Pratap, Cheol Lee, Lisa Zhang, Hung Dar Chen, Irina Arnaoutova, Brian C. Mansfield, Janice Y. Chou
Glycogen storage disease type Ib (GSD-Ib), caused by a deficiency of the glucose-6-phosphate transporter (G6PT), is characterized by impaired glucose homeostasis and progressive renal dysfunction. Using G6pt-deficient (G6pt−/−) mice, which closely recapitulate the pathophysiology of GSD-Ib, we previously demonstrated that GSD-Ib nephropathy is marked by disrupted renal homeostasis, acute kidney injury, and fibrosis. However, due to the severity of the metabolic defect, G6pt−/− mice typically fail to survive beyond three weeks of age, limiting the study of disease progression in adulthood. To overcome this limitation, we generated liver human G6PT-augmented, kidney G6PT-deficient (L-hG6PT/K−/−) mice, which restore hepatic G6PT expression to support survival while maintaining G6PT deficiency in the kidney. We show that adult L-hG6PT/K−/− mice develop renal abnormalities similar to those seen in 3-week-old global G6pt−/− mice. Importantly, unlike the younger cohort, 12-week-old L-hG6PT/K−/− mice exhibit a progressive decline in renal function accompanied by marked fibrosis. These findings establish L-hG6PT/K−/− mice as a robust and physiologically relevant model for investigating the mechanisms and progression of GSD-Ib nephropathy in mature animals.
糖原储存病Ib型(GSD-Ib)是由葡萄糖-6-磷酸转运体(G6PT)缺乏引起的,其特征是葡萄糖稳态受损和进行性肾功能障碍。使用G6pt缺陷(G6pt-/-)小鼠,这与GSD-Ib的病理生理密切相关,我们之前证明了GSD-Ib肾病的特征是肾稳态破坏、急性肾损伤和纤维化。然而,由于代谢缺陷的严重性,G6pt-/-小鼠通常不能存活超过三周龄,限制了对成年期疾病进展的研究。为了克服这一限制,我们产生了肝脏G6PT增强,肾脏G6PT缺乏(L-hG6PT/K-/-)小鼠,恢复肝脏G6PT表达以支持生存,同时维持肾脏G6PT缺乏。我们发现,成年L-hG6PT/K-/-小鼠出现的肾脏异常与3周大的全球G6pt-/-小鼠相似。重要的是,与年轻的队列不同,12周龄的L-hG6PT/K-/-小鼠表现出肾功能的进行性下降,并伴有明显的纤维化。这些发现建立了L-hG6PT/K-/-小鼠作为研究成熟动物GSD-Ib肾病的机制和进展的强大的生理相关模型。
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引用次数: 0
Adenylosuccinate synthetase deficiency and purine nucleotide cycle disruption impair neuromuscular function in Caenorhabditis elegans 腺苷琥珀酸合成酶缺乏和嘌呤核苷酸循环中断损害秀丽隐杆线虫的神经肌肉功能。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-10 DOI: 10.1016/j.ymgme.2025.109261
Rishika R. Patil, Latisha P. Franklin, Melinda D. Jin, Wendy Hanna-Rose
The critical role of the purine nucleotide cycle (PNC) in human health is underscored by the fact that mutations in adenylosuccinate synthetase (ADSS) and adenylosuccinate lyase (ADSL), two of its three enzymes, are associated with severe inborn errors of purine metabolism. We use Caenorhabditis elegans to investigate the biological roles of the PNC and to characterize developmental and behavioral functions of ADSS and ADSL. Here we report that adss-1, which encodes ADSS in C. elegans, is required for fertility and locomotion. adss-1 loss-of-function mutants also have small body size, and their development is severely delayed. These phenotypes are shared with adsl-1, which encodes ADSL, suggesting that an intact PNC is required for C. elegans development. Interestingly, adss-1 and adsl-1 each have unique phenotypes not shared with the other. adss-1-specific phenotypes include excessive excitatory (or decreased inhibitory) synaptic transmission at the neuromuscular junction and impaired mechanosensation, suggesting an important function in the nervous system. We have also established a powerful model for further investigation of how ADSS activity impacts mobility, providing insight into the poorly understood molecular mechanisms driving phenotypic outcomes in ADSS1 deficiency.
嘌呤核苷酸循环(PNC)在人类健康中的关键作用被以下事实所强调:嘌呤核苷酸循环三种酶中的两种——腺苷琥珀酸合成酶(ADSS)和腺苷琥珀酸裂解酶(ADSL)的突变与嘌呤代谢的严重先天性错误有关。我们利用秀丽隐杆线虫研究了PNC的生物学作用,并对ADSS和ADSL的发育和行为功能进行了表征。在这里,我们报道了线虫中编码ADSS的ADSS -1是繁殖和运动所必需的。Adss-1功能丧失突变体也具有较小的体型,其发育严重延迟。这些表型与编码ADSL的ADSL -1共享,这表明秀丽隐杆线虫的发育需要完整的PNC。有趣的是,adss-1和adsl-1各有独特的表型,彼此不共享。adss-1特异性表型包括神经肌肉连接处兴奋性突触传递过度(或抑制性突触传递减少)和机械感觉受损,表明其在神经系统中具有重要功能。我们还建立了一个强大的模型,用于进一步研究ADSS活性如何影响移动性,从而深入了解ADSS1缺乏症中驱动表型结果的分子机制。
{"title":"Adenylosuccinate synthetase deficiency and purine nucleotide cycle disruption impair neuromuscular function in Caenorhabditis elegans","authors":"Rishika R. Patil,&nbsp;Latisha P. Franklin,&nbsp;Melinda D. Jin,&nbsp;Wendy Hanna-Rose","doi":"10.1016/j.ymgme.2025.109261","DOIUrl":"10.1016/j.ymgme.2025.109261","url":null,"abstract":"<div><div>The critical role of the purine nucleotide cycle (PNC) in human health is underscored by the fact that mutations in adenylosuccinate synthetase (ADSS) and adenylosuccinate lyase (ADSL), two of its three enzymes, are associated with severe inborn errors of purine metabolism. We use <em>Caenorhabditis elegans</em> to investigate the biological roles of the PNC and to characterize developmental and behavioral functions of ADSS and ADSL. Here we report that <em>adss-1</em>, which encodes ADSS in <em>C. elegans</em>, is required for fertility and locomotion. <em>adss-1</em> loss-of-function mutants also have small body size, and their development is severely delayed. These phenotypes are shared with <em>adsl-1</em>, which encodes ADSL, suggesting that an intact PNC is required for <em>C. elegans</em> development. Interestingly, <em>adss-1</em> and <em>adsl-1</em> each have unique phenotypes not shared with the other. <em>adss-1</em>-specific phenotypes include excessive excitatory (or decreased inhibitory) synaptic transmission at the neuromuscular junction and impaired mechanosensation, suggesting an important function in the nervous system. We have also established a powerful model for further investigation of how ADSS activity impacts mobility, providing insight into the poorly understood molecular mechanisms driving phenotypic outcomes in ADSS1 deficiency.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109261"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Detecting mitochondrial electron transport chain enzyme defects in low-heteroplasmy single large-scale mtDNA deletion syndromes (SLSMDSs) 低异质性单大规模mtDNA缺失综合征(SLSMDSs)线粒体电子传递链酶缺陷检测
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-08 DOI: 10.1016/j.ymgme.2025.109260
Xueyang Pan , Yue Wang , Ning Liu , Xi Luo , V. Reid Sutton , William J. Craigen , Qin Sun
Large deletions in multi-copy mitochondrial DNA (mtDNA) are associated with chronic progressive external ophthalmoplegia (CPEO), Kearns-Sayre syndrome (KSS), and Pearson syndrome (PS), collectively referred to as single large-scale mtDNA deletion syndromes (SLSMDSs). These deletions are typically sporadic and heteroplasmic, yet the relationship between heteroplasmy levels and disease severity remains uncertain, particularly for low level deletions, making pathogenicity assessment challenging.
To evaluate the functional impact of mtDNA deletions in muscle, we retrospectively analyzed 1104 consecutive clinical cases with both mtDNA sequencing and mitochondrial electron transport chain (ETC) enzyme assays performed on the same muscle specimen. Fifteen cases (1.4 %) carried a single large mtDNA deletion and exhibited clinical features consistent with the CPEO/KSS spectrum. Of these, seven showed ETC deficiencies despite low deletion heteroplasmy levels (<10 % in all cases). Four had enzyme deficiencies defined to a single complex, while three had deficiencies in multiple complexes. Complex IV was most frequently impaired, whereas nuclear-encoded complex II activity remained normal in all samples. Notably, the pattern of ETC impairment did not fully correlate with the specific mitochondrial genes disrupted by the deletions.
These findings demonstrate that mitochondrial dysfunction can occur at mtDNA deletion heteroplasmy levels far below conventional pathogenic thresholds. This highlights the diagnostic relevance of low-level mtDNA deletions and supports the integration of molecular and functional testing in accurate SLSMDS diagnosis.
多拷贝线粒体DNA (mtDNA)的大缺失与慢性进行性外眼肌麻痹(CPEO)、卡恩斯-塞尔综合征(KSS)和皮尔逊综合征(PS)有关,统称为单大规模mtDNA缺失综合征(slsmds)。这些缺失通常是散发性和异质性的,但异质性水平与疾病严重程度之间的关系仍然不确定,特别是对于低水平的缺失,这使得致病性评估具有挑战性。为了评估mtDNA缺失对肌肉功能的影响,我们回顾性分析了1104例连续的临床病例,对同一肌肉标本进行了mtDNA测序和线粒体电子传递链(ETC)酶测定。15例(1.4%)携带单个大mtDNA缺失,表现出与CPEO/KSS谱一致的临床特征。其中7例显示ETC缺陷,尽管缺失异质性水平较低(
{"title":"Detecting mitochondrial electron transport chain enzyme defects in low-heteroplasmy single large-scale mtDNA deletion syndromes (SLSMDSs)","authors":"Xueyang Pan ,&nbsp;Yue Wang ,&nbsp;Ning Liu ,&nbsp;Xi Luo ,&nbsp;V. Reid Sutton ,&nbsp;William J. Craigen ,&nbsp;Qin Sun","doi":"10.1016/j.ymgme.2025.109260","DOIUrl":"10.1016/j.ymgme.2025.109260","url":null,"abstract":"<div><div>Large deletions in multi-copy mitochondrial DNA (mtDNA) are associated with chronic progressive external ophthalmoplegia (CPEO), Kearns-Sayre syndrome (KSS), and Pearson syndrome (PS), collectively referred to as single large-scale mtDNA deletion syndromes (SLSMDSs). These deletions are typically sporadic and heteroplasmic, yet the relationship between heteroplasmy levels and disease severity remains uncertain, particularly for low level deletions, making pathogenicity assessment challenging.</div><div>To evaluate the functional impact of mtDNA deletions in muscle, we retrospectively analyzed 1104 consecutive clinical cases with both mtDNA sequencing and mitochondrial electron transport chain (ETC) enzyme assays performed on the same muscle specimen. Fifteen cases (1.4 %) carried a single large mtDNA deletion and exhibited clinical features consistent with the CPEO/KSS spectrum. Of these, seven showed ETC deficiencies despite low deletion heteroplasmy levels (&lt;10 % in all cases). Four had enzyme deficiencies defined to a single complex, while three had deficiencies in multiple complexes. Complex IV was most frequently impaired, whereas nuclear-encoded complex II activity remained normal in all samples. Notably, the pattern of ETC impairment did not fully correlate with the specific mitochondrial genes disrupted by the deletions.</div><div>These findings demonstrate that mitochondrial dysfunction can occur at mtDNA deletion heteroplasmy levels far below conventional pathogenic thresholds. This highlights the diagnostic relevance of low-level mtDNA deletions and supports the integration of molecular and functional testing in accurate SLSMDS diagnosis.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109260"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mucopolysaccharidosis VI: Therapeutic strategies and perspectives 粘多糖病VI:治疗策略和前景。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-07 DOI: 10.1016/j.ymgme.2025.109255
Andrés Felipe Leal , Luis Eduardo Prieto , Harry Pachajoa , Shunji Tomatsu
Mucopolysaccharidosis VI, also known as Maroteaux-Lamy syndrome, is a lysosomal storage disorder (LSD) caused by pathogenic mutations in the ARSB gene, resulting in arylsulfatase (ARSB) deficiency and the lysosomal accumulation of dermatan sulfate (DS) and chondroitin 4-sulfate (C4S). DS and C4S accumulation leads to multisystemic symptoms in MPS VI patients in cartilage, bone, heart valves, cornea, liver, and respiratory tract. Currently, enzyme replacement therapy (ERT) is the only approved treatment for patients with MPS VI, providing clinical benefits that include increased survival and improved quality of life. However, ERT has a limited impact on bone manifestations. Significant advances have been made in gene therapy (GT) using classical adeno-associated virus and the CRISPR/Cas9 system, providing promising alternatives in MPS VI. Importantly, hematopoietic stem cell transplantation (HSCT) in combination with GT may also offer a novel alternative. Additionally, substrate reduction therapy with odiparcil, immunomodulation, and stop codon read-through therapies have been explored in MPS VI. Future directions in MPS VI should include targeting cellular alterations, such as mitochondrial dysfunction, exploring cartilage-targeting alternatives, and implementing pharmacological chaperones. This manuscript highlights recent progress and emerging strategies for treating MPS VI.
粘多糖病(Mucopolysaccharidosis VI)又称Maroteaux-Lamy综合征,是一种由ARSB基因致病性突变引起的溶酶体贮积障碍(LSD),导致芳基硫酸酯酶(ARSB)缺乏,溶酶体积聚硫酸皮肤素(DS)和硫酸软骨素4 (C4S)。DS和C4S积累导致MPS VI患者软骨、骨、心脏瓣膜、角膜、肝脏和呼吸道的多系统症状。目前,酶替代疗法(ERT)是唯一被批准用于MPS VI患者的治疗方法,提供包括增加生存期和改善生活质量在内的临床益处。然而,ERT对骨表现的影响有限。使用经典腺相关病毒和CRISPR/Cas9系统的基因治疗(GT)取得了重大进展,为MPS VI提供了有希望的替代方案。重要的是,造血干细胞移植(HSCT)联合GT也可能提供一种新的替代方案。此外,在MPS VI中已经探索了底物减少疗法、免疫调节和停止密码子读取疗法。MPS VI的未来方向应该包括靶向细胞改变,如线粒体功能障碍,探索软骨靶向替代品,以及实施药物伴侣。这篇文章强调了治疗MPS VI的最新进展和新兴策略。
{"title":"Mucopolysaccharidosis VI: Therapeutic strategies and perspectives","authors":"Andrés Felipe Leal ,&nbsp;Luis Eduardo Prieto ,&nbsp;Harry Pachajoa ,&nbsp;Shunji Tomatsu","doi":"10.1016/j.ymgme.2025.109255","DOIUrl":"10.1016/j.ymgme.2025.109255","url":null,"abstract":"<div><div>Mucopolysaccharidosis VI, also known as Maroteaux-Lamy syndrome, is a lysosomal storage disorder (LSD) caused by pathogenic mutations in the <em>ARSB</em> gene, resulting in arylsulfatase (ARSB) deficiency and the lysosomal accumulation of dermatan sulfate (DS) and chondroitin 4-sulfate (C4S). DS and C4S accumulation leads to multisystemic symptoms in MPS VI patients in cartilage, bone, heart valves, cornea, liver, and respiratory tract. Currently, enzyme replacement therapy (ERT) is the only approved treatment for patients with MPS VI, providing clinical benefits that include increased survival and improved quality of life. However, ERT has a limited impact on bone manifestations. Significant advances have been made in gene therapy (GT) using classical adeno-associated virus and the CRISPR/Cas9 system, providing promising alternatives in MPS VI. Importantly, hematopoietic stem cell transplantation (HSCT) in combination with GT may also offer a novel alternative. Additionally, substrate reduction therapy with odiparcil, immunomodulation, and stop codon read-through therapies have been explored in MPS VI. Future directions in MPS VI should include targeting cellular alterations, such as mitochondrial dysfunction, exploring cartilage-targeting alternatives, and implementing pharmacological chaperones. This manuscript highlights recent progress and emerging strategies for treating MPS VI.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109255"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amino acid supplementation in patients affected by leukoencephalopathies associated with mitochondrial aminoacyl tRNA synthetase pathogenic variants: Pilot clinical trial in adults and review of literature 氨基酸补充对线粒体氨基酰基tRNA合成酶致病变异相关白质脑病患者的影响:成人临床试验和文献回顾
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-06 DOI: 10.1016/j.ymgme.2025.109259
Alessia Catania , Silvia Marchet , Krisztina Einvag , Eleonora Lamantea , Ettore Salsano , Daniele Ghezzi , Costanza Lamperti

Background

Mitochondrial aminoacyl tRNA synthetase (mt-ARS) related disorders represent a widely heterogeneous group of diseases affecting the efficiency of mitochondrial protein synthesis.
AARS2 and DARS2 biallelic mutations are associated with clinical syndromes prominently characterized by diffuse leukoencephalopathy with a highly variable age of onset, ranging from early infancy to adulthood.
Preliminary in vitro results on patients' fibroblasts and some anecdotal reports on patients affected by mt-ARS related disease have suggested a possible benefit of supplementation with the specific substrate amino acid of the defective mt-ARS.

Methods

We recruited 6 adult patients affected by AARS2 (n = 2) and DARS2 (n = 4) related leukoencephalopathies and started an oral supplementation with alanine and aspartate, respectively, for a total duration of 2 years. Therapeutic efficacy and safety were assessed through clinical examinations, standardized scales, functional tests, quality of life (QoL) scores, brain MRI, and laboratory analyses.

Results

Overall, the treatment was safe and well tolerated by all patients, but efficacy endpoints were not met as no significant improvements were observed in global, cognitive, or motor scores.; nonetheless, all patients but one remained clinically stable.

Conclusions

Despite inherent limitations of this pivotal trial, our findings suggest that specific amino acid supplementation is a safe intervention but do not yield a clear symptomatic benefit; nevertheless, we cannot exclude a potential role in stabilizing the clinical condition in adult patients with DARS2-related disorders.
线粒体氨酰基tRNA合成酶(mt-ARS)相关疾病是影响线粒体蛋白质合成效率的广泛异质性疾病。AARS2和DARS2双等位基因突变与以弥漫性白质脑病为显著特征的临床综合征相关,其发病年龄变化很大,从婴儿期早期到成年期不等。对患者成纤维细胞的初步体外实验结果和一些关于mt-ARS相关疾病患者的轶事报道表明,补充缺陷mt-ARS的特定底物氨基酸可能有益。方法:我们招募了6例患有AARS2 (n = 2)和DARS2 (n = 4)相关白质脑病的成年患者,分别开始口服丙氨酸和天冬氨酸,总共持续2年。通过临床检查、标准化量表、功能测试、生活质量(QoL)评分、脑MRI和实验室分析来评估治疗效果和安全性。结果总体而言,该治疗对所有患者都是安全且耐受性良好的,但未达到疗效终点,因为在整体、认知或运动评分方面未观察到显着改善。尽管如此,除了一名患者外,所有患者在临床上都保持稳定。尽管这项关键试验存在固有的局限性,但我们的研究结果表明,补充特定氨基酸是一种安全的干预措施,但不会产生明显的症状益处;然而,我们不能排除在稳定dars2相关疾病成人患者临床状况方面的潜在作用。
{"title":"Amino acid supplementation in patients affected by leukoencephalopathies associated with mitochondrial aminoacyl tRNA synthetase pathogenic variants: Pilot clinical trial in adults and review of literature","authors":"Alessia Catania ,&nbsp;Silvia Marchet ,&nbsp;Krisztina Einvag ,&nbsp;Eleonora Lamantea ,&nbsp;Ettore Salsano ,&nbsp;Daniele Ghezzi ,&nbsp;Costanza Lamperti","doi":"10.1016/j.ymgme.2025.109259","DOIUrl":"10.1016/j.ymgme.2025.109259","url":null,"abstract":"<div><h3>Background</h3><div>Mitochondrial aminoacyl tRNA synthetase (mt-ARS) related disorders represent a widely heterogeneous group of diseases affecting the efficiency of mitochondrial protein synthesis.</div><div><em>AARS2</em> and <em>DARS2</em> biallelic mutations are associated with clinical syndromes prominently characterized by diffuse leukoencephalopathy with a highly variable age of onset, ranging from early infancy to adulthood.</div><div>Preliminary in vitro results on patients' fibroblasts and some anecdotal reports on patients affected by mt-ARS related disease have suggested a possible benefit of supplementation with the specific substrate amino acid of the defective mt-ARS.</div></div><div><h3>Methods</h3><div>We recruited 6 adult patients affected by <em>AARS2</em> (<em>n</em> = 2) and <em>DARS2</em> (<em>n</em> = 4) related leukoencephalopathies and started an oral supplementation with alanine and aspartate, respectively, for a total duration of 2 years. Therapeutic efficacy and safety were assessed through clinical examinations, standardized scales, functional tests, quality of life (QoL) scores, brain MRI, and laboratory analyses.</div></div><div><h3>Results</h3><div>Overall, the treatment was safe and well tolerated by all patients, but efficacy endpoints were not met as no significant improvements were observed in global, cognitive, or motor scores.; nonetheless, all patients but one remained clinically stable.</div></div><div><h3>Conclusions</h3><div>Despite inherent limitations of this pivotal trial, our findings suggest that specific amino acid supplementation is a safe intervention but do not yield a clear symptomatic benefit; nevertheless, we cannot exclude a potential role in stabilizing the clinical condition in adult patients with <em>DARS2</em>-related disorders.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109259"},"PeriodicalIF":3.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional ability profiles in beta-propeller protein-associated neurodegeneration (BPAN) β -螺旋桨蛋白相关神经变性(BPAN)的功能能力概况。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-10-06 DOI: 10.1016/j.ymgme.2025.109253
Francesco Gavazzi , Samuel R. Pierce , Vanessa Smith , Eric Yang , Julie Skorup , Kristy Pucci , Emma Kotes , Allan M. Glanzman , Stacy V. Cusack , Todd Levy , Holly Dubbs , Emma Wiener , Sarah Woidill , Joseph Vithayathil , Abbas Jawad , Nivedita Thakur , Laura A. Adang

Background

Beta-propeller Protein-Associated Neurodegeneration (BPAN) is a rare neurodevelopmental degenerative disorder caused by pathogenic variants in WDR45 leading to brain iron accumulation. Its rarity and complex clinical course make it difficult to select appropriate clinical outcome assessments (COAs). This study evaluates established COAs for feasibility and effectiveness in capturing BPAN's functional ability profiles exploring cognitive, motor, and behavioral features.

Methods

We performed an observational study. Children were recruited as part of the Myelin Disorders Biorepository Project at the Children's Hospital of Philadelphia. We administered the Gross Motor Function Measure-88 (GMFM-88), the Leiter International Performance Scale (Leiter-3), and the Vineland Adaptive Behavior Scale (VABS-3). A Rasch validated version of the GMFM-88, the GMFM-66, was derived from the GMFM-88 data. Descriptive statistics and Spearman's rank correlation were used to compare assessments. Statistical analyses were performed to compare performance across cohorts and assess correlations, with significance defined as p < 0.05.

Results

Fifty-three individuals (43 females, 10 males) with molecularly confirmed BPAN participated. The VABS-3 (n = 53) showed a decline in adaptive skills over time, with significant differences between Communication and Socialization Domain performance (Kruskal-Wallis test with Dunn's correction p < 0.0001). GMFM-88 assessments (n = 32) showed a median performance of 33.4 %. Patient participation/behavior affected data completeness. The more limited GMFM-66 correlated better with the VABS-3 Gross Motor subdomain than the GMFM-88 (r = 0.94, r = 0.73, respectively). The Leiter-3 (n = 36) demonstrated significant non-verbal cognitive impairment, although there were behavioral challenges which impacted implementation. Longitudinal VABS-3 data revealed a median − 2.9 points/year decline in Adaptive Behavior Composite scores, reflecting progressive functional loss.

Discussion

This study highlights key considerations for selecting COAs in BPAN. The panel of COAs should accommodate the behavioral challenges associated with BPAN that can limit participant compliance with testing. The abbreviated GMFM-66 was a more reliable tool to capture motor skills. Similarly, behavioral difficulties impacted Leiter-3 performance, which demonstrated general impairment in non-verbal cognitive skills. The VABS-3 effectively tracked adaptive function decline, demonstrating feasibility for longitudinal monitoring. Future studies should expand cohort size, refine assessment strategies, and align measures with disease progression to optimize clinical trial readiness.
背景:β -螺旋桨蛋白相关神经变性(BPAN)是一种罕见的神经发育退行性疾病,由WDR45致病性变异导致脑铁积累引起。其罕见性和复杂的临床过程使其难以选择适当的临床结果评估(COAs)。本研究评估了已建立的coa在捕捉BPAN功能能力特征方面的可行性和有效性,探索认知、运动和行为特征。方法:采用观察性研究。儿童被招募作为费城儿童医院髓磷脂疾病生物存储项目的一部分。我们使用了大运动功能量表-88 (GMFM-88)、Leiter国际表现量表(Leiter-3)和Vineland适应行为量表(VABS-3)。根据GMFM-88的数据衍生出了一种经过Rasch验证的GMFM-66型导弹。使用描述性统计和Spearman等级相关来比较评估。进行统计分析以比较各队列的表现并评估相关性,显著性定义为p。结果:53人(43名女性,10名男性)参与了分子证实的BPAN。VABS-3 (n = 53)显示适应技能随着时间的推移而下降,在沟通和社交领域的表现之间存在显著差异(Kruskal-Wallis测试与Dunn的修正)。coa小组应该适应与BPAN相关的行为挑战,这些挑战可能限制参与者遵守测试。缩写的GMFM-66是一种更可靠的捕捉运动技能的工具。同样,行为困难影响了字母3的表现,这表明了非语言认知技能的普遍损害。VABS-3有效跟踪了自适应功能衰退,证明了纵向监测的可行性。未来的研究应扩大队列规模,完善评估策略,并根据疾病进展调整措施,以优化临床试验准备。
{"title":"Functional ability profiles in beta-propeller protein-associated neurodegeneration (BPAN)","authors":"Francesco Gavazzi ,&nbsp;Samuel R. Pierce ,&nbsp;Vanessa Smith ,&nbsp;Eric Yang ,&nbsp;Julie Skorup ,&nbsp;Kristy Pucci ,&nbsp;Emma Kotes ,&nbsp;Allan M. Glanzman ,&nbsp;Stacy V. Cusack ,&nbsp;Todd Levy ,&nbsp;Holly Dubbs ,&nbsp;Emma Wiener ,&nbsp;Sarah Woidill ,&nbsp;Joseph Vithayathil ,&nbsp;Abbas Jawad ,&nbsp;Nivedita Thakur ,&nbsp;Laura A. Adang","doi":"10.1016/j.ymgme.2025.109253","DOIUrl":"10.1016/j.ymgme.2025.109253","url":null,"abstract":"<div><h3>Background</h3><div>Beta-propeller Protein-Associated Neurodegeneration (BPAN) is a rare neurodevelopmental degenerative disorder caused by pathogenic variants in <em>WDR45</em> leading to brain iron accumulation. Its rarity and complex clinical course make it difficult to select appropriate clinical outcome assessments (COAs). This study evaluates established COAs for feasibility and effectiveness in capturing BPAN's functional ability profiles exploring cognitive, motor, and behavioral features.</div></div><div><h3>Methods</h3><div>We performed an observational study. Children were recruited as part of the Myelin Disorders Biorepository Project at the Children's Hospital of Philadelphia. We administered the Gross Motor Function Measure-88 (GMFM-88), the Leiter International Performance Scale (Leiter-3), and the Vineland Adaptive Behavior Scale (VABS-3). A Rasch validated version of the GMFM-88, the GMFM-66, was derived from the GMFM-88 data. Descriptive statistics and Spearman's rank correlation were used to compare assessments. Statistical analyses were performed to compare performance across cohorts and assess correlations, with significance defined as <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Fifty-three individuals (43 females, 10 males) with molecularly confirmed BPAN participated. The VABS-3 (<em>n</em> = 53) showed a decline in adaptive skills over time, with significant differences between Communication and Socialization Domain performance (Kruskal-Wallis test with Dunn's correction <em>p</em> &lt; 0.0001). GMFM-88 assessments (<em>n</em> = 32) showed a median performance of 33.4 %. Patient participation/behavior affected data completeness. The more limited GMFM-66 correlated better with the VABS-3 Gross Motor subdomain than the GMFM-88 (<em>r</em> = 0.94, <em>r</em> = 0.73, respectively). The Leiter-3 (<em>n</em> = 36) demonstrated significant non-verbal cognitive impairment, although there were behavioral challenges which impacted implementation. Longitudinal VABS-3 data revealed a median − 2.9 points/year decline in Adaptive Behavior Composite scores, reflecting progressive functional loss.</div></div><div><h3>Discussion</h3><div>This study highlights key considerations for selecting COAs in BPAN. The panel of COAs should accommodate the behavioral challenges associated with BPAN that can limit participant compliance with testing. The abbreviated GMFM-66 was a more reliable tool to capture motor skills. Similarly, behavioral difficulties impacted Leiter-3 performance, which demonstrated general impairment in non-verbal cognitive skills. The VABS-3 effectively tracked adaptive function decline, demonstrating feasibility for longitudinal monitoring. Future studies should expand cohort size, refine assessment strategies, and align measures with disease progression to optimize clinical trial readiness.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109253"},"PeriodicalIF":3.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Molecular genetics and metabolism
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