Mutations in the GLA Gene and LysoGb3: Is It Really Anderson-Fabry Disease?
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Published:2018-11-23
Issue:12
Volume:19
Page:3726
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ISSN:1422-0067
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Container-title:International Journal of Molecular Sciences
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language:en
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Short-container-title:IJMS
Author:
Duro Giovanni, Zizzo Carmela, Cammarata Giuseppe, Burlina Alessandro, Burlina Alberto, Polo Giulia, Scalia Simone, Oliveri Roberta, Sciarrino Serafina, Francofonte Daniele, Alessandro Riccardo, Pisani Antonio, Palladino Giuseppe, Napoletano Rosa, Tenuta Maurizio, Masarone Daniele, Limongelli Giuseppe, Riccio Eleonora, Frustaci Andrea, Chimenti Cristina, Ferri Claudio, Pieruzzi Federico, Pieroni Maurizio, Spada Marco, Castana Cinzia, Caserta Marina, Monte Ines, Rodolico Margherita, Feriozzi Sandro, Battaglia Yuri, Amico Luisa, Losi Maria, Autore Camillo, Lombardi Marco, Zoccali Carmine, Testa Alessandra, Postorino Maurizio, Mignani Renzo, Zachara Elisabetta, Giordano Antonello, Colomba PaoloORCID
Abstract
Anderson-Fabry disease (FD) is a rare, progressive, multisystem storage disorder caused by the partial or total deficit of the lysosomal enzyme α-galactosidase A (α-Gal A). It is an X-linked, lysosomal enzymopathy due to mutations in the galactosidase alpha gene (GLA), encoding the α-Gal A. To date, more than 900 mutations in this gene have been described. In our laboratories, the study of genetic and enzymatic alterations related to FD was performed in about 17,000 subjects with a symptomatology referable to this disorder. The accumulation of globotriaosylsphingosine (LysoGb3) was determined in blood of positives. Exonic mutations in the GLA gene were detected in 471 patients (207 Probands and 264 relatives): 71.6% of mutations were associated with the classic phenotype, 19.8% were associated with the late-onset phenotype, and 8.6% of genetic variants were of unknown significance (GVUS). The accumulation of LysoGb3 was found in all male patients with a mutation responsible for classic or late-onset FD. LysoGb3 levels were consistent with the type of mutations and the symptomatology of patients. α-Gal A activity in these patients is absent or dramatically reduced. In recent years, confusion about the pathogenicity of some mutations led to an association between non-causative mutations and FD. Our study shows that the identification of FD patients is possible by associating clinical history, GLA gene analysis, α-Gal A assay, and blood accumulation of LysoGB3. In our experience, LysoGB3 can be considered a reliable marker, which is very useful to confirm the diagnosis of Fabry disease.
Subject
Inorganic Chemistry,Organic Chemistry,Physical and Theoretical Chemistry,Computer Science Applications,Spectroscopy,Molecular Biology,General Medicine,Catalysis
Cited by
74 articles.
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