Mucopolysaccharidosis (MPS) and mucolipidosis(ML) belong to a group of rare genetic disorders of lysosomal enzymes and share some clinical manifestations. MPS is characterized by the accumulation of glycosaminoglycans (GAG) and results from the impaired function of one of 11 enzymes required for normal GAG degradation. ML, which is clinically similar to several forms of MPS, is caused by deficiency of Nacetylglucosamine-1-phosphotransferase activity. Therapeutic strategies for MPS, including enzyme replacement therapy and bone marrow transplantation, have been developed with some success. In this review, we discuss clinical feature, diagnostic methods, management and the present status of research on MPS and ML.
Bone Marrow Transplantation ; Enzyme Replacement Therapy ; Glycosaminoglycans ; Mucolipidoses* ; Mucopolysaccharidoses*

Fabry disease is a rare, X-linked inborn error of glycosphingolipid catabolism caused by a mutation in the gene encoding the alpha-galactosidase A (GLA) enzyme. We report two cases of Fabry disease in a 12-year-old boy who had acroparesthesia and in his elder brother with milder symptoms who were diagnosed by GLA activity assays and the presence of the GLA gene mutation.
alpha-Galactosidase ; Child ; Enzyme Replacement Therapy ; Fabry Disease ; Humans ; Siblings

Lysosomal storage disorders (LSDs) are a group of single-gene inherited metabolic diseases caused by defects in lysosomal enzymes or function-related proteins. Enzyme replacement therapy is the main treatment method in clinical practice, but it has a poor effect in patients with neurological symptoms. With the rapid development of multi-omics, sequencing technology, and bioengineering, gene therapy has been applied in patients with LSDs. As one of the vectors of gene therapy, adeno-associated virus (AAV) has good prospects in the treatment of genetic and metabolic diseases. More and more studies have shown that AAV-mediated gene therapy is effective in LSDs. This article reviews the application of AAV-mediated gene therapy in LSDs.
Humans ; Dependovirus/genetics* ; Genetic Therapy/methods* ; Lysosomal Storage Diseases/therapy* ; Enzyme Replacement Therapy ; Proteins/genetics*

Fabry disease is a rare X-linked hereditary condition caused by mutations in the α-galactosidase A (GLA) gene, resulting in decreased α-GAL A enzyme activity. The clinical manifestations of Fabry disease are diverse, which leads to delays in diagnosis and treatment, thereby increasing the disease burden for patients and their families. Given its characteristics, multidisciplinary treatment (MDT) is critical for the long-term management of Fabry disease, and should include nephrology departments, cardiovascular departments, neurology departments, and pediatric department, among others. This study focuses on early screening for Fabry disease, the indication for initiating enzyme replacement therapy, pre-treatment evaluation, and monitoring to provide practical guidance for Chinese clinicians.
Child ; Humans ; Fabry Disease/drug therapy* ; alpha-Galactosidase/therapeutic use* ; Mutation ; Enzyme Replacement Therapy

Pompe disease, also known as glycogen storage disease type Ⅱ, is a rare autosomal recessive disease. With the application of enzyme replacement therapy, more and more patients with Pompe disease can survive to adulthood, and nervous system-related clinical manifestations gradually emerge. Nervous system involvement seriously affects the quality of life of patients with Pompe disease, and a systematic understanding of the clinical manifestations, imaging features and pathological changes of nervous system injury in Pompe disease is of great significance for the early identification and intervention of Pompe disease. This article reviews the research progress of neurological damage in Pompe disease.
Humans ; Glycogen Storage Disease Type II/drug therapy* ; alpha-Glucosidases ; Quality of Life ; Enzyme Replacement Therapy

We evaluated the urinary glucose tetrasaccharide (Glc4) assay using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The calibration curve was linear over a range of 5-500 micromol/L. Performance parameters such as intra- and inter-day imprecision CVs were 6.52-14.6% and 11.5-13.2%, respectively. The mean concentrations of urinary Glc4 in 27 normal controls and 3 pseudodeficiency patients were 1.5 and 12.1 mmol/mol creatinine, respectively. Urinary Glc4 concentration in a patient with Pompe disease was 171.3 mmol/mol creatinine, which decreased to 130.9 mmol/mol following enzyme replacement therapy. Based on our results, we suggest that the urinary Glc4 assay using UPLC-MS/MS can be a reliable diagnostic tool for identification of patients with Pompe disease.
Calibration ; Creatinine ; Diagnosis* ; Enzyme Replacement Therapy ; Glucose* ; Glycogen Storage Disease Type II* ; Humans ; Mass Spectrometry*

Inherited metabolic disease is rare disorders that show symptoms mainly in pediatric age and early treatment is important for preventing complications of the disease. Recent development in molecular and biochemical techniques help clinicians with proper diagnosis of patients, however, many of the disease still remain lack of effective therapeutic strategies. Better understanding on biochemical and molecular basis of pathogenesis of the disease combined with advanced medical care would provide new sight on the disease that can also improve the quality of life and long-term prognosis of patients. Traditionally, there are several modalities in the treatment of metabolic diseases depend on the biochemical basis of the disease such as diet restriction, removing or blocking the production of toxic metabolites, and stimulating residual enzyme activity. The inherited metabolic disease is not familiar for many clinicians because the diagnosis is troublesome, treatment is complicated and prognosis may not as good as expected in other diseases. Recently, new therapeutic regimens have been introduced that can significantly improve the medical care of patients with metabolic disease. Enzyme replacement therapy has showed promising efficacy for lysosomal storage disease, bone marrow transplantation is effective in some disease and gene therapy has been trying for different diseases. The new trials for treatment of the disease will give us promising insight on the disease and most clinicians should have more interest in medical progress of the metabolic disease.
Bone Marrow Transplantation ; Diagnosis ; Diet ; Enzyme Replacement Therapy ; Genetic Therapy ; Humans ; Lysosomal Storage Diseases ; Metabolic Diseases* ; Metabolism ; Prognosis ; Quality of Life

Treatment for chronic pancreatitis (CP) should be started early to prevent further pancreatic fibrosis and managed with a multidisciplinary approach to prevent complications and to maintain a good quality of life. The management strategies of CP can be divided into medical, endoscopic, and surgical treatment. The role of pancreatic enzymes and antioxidants for pain relief is not clearly defined, but their role in maintaining nutritional support by correcting exocrine insufficiency is well established. Endoscopic treatment is applied for resolution of pancreatic or bile duct strictures, clearance of pancreatic duct stones, and pseudocyst drainage. Endosonography-guided celiac plexus or celiac ganglia block for pain relief are known to be safe procedures but evidence for their effectiveness is still lacking. Surgery is commonly recommended when endoscopic therapy fails or there is suspicion of malignancy. New evidence-based guidelines for the management of CP are needed.
Antioxidants/therapeutic use ; Cholangiopancreatography, Endoscopic Retrograde ; Endosonography ; Enzyme Replacement Therapy ; Fibrosis ; Gallstones/therapy ; Humans ; Lithotripsy ; Pancreas/pathology ; Pancreatitis, Chronic/*drug therapy/pathology

BACKGROUND: This study is aimed to identify Gaucher disease(GD) patients(pts.) in Korea in order to better understand the incidence, clinical phenotype and its natural history and to establish pt. registry. The registry is to provide collective data, which will lead to early diagnosis, effective treatment and better management of pts. METHODS: (1)Questionnaires designed to identify GD pts. were sent to all members of Korean Pediatric Hemato-Oncology Society in 1997 and other inquiring physicians. (2) All published papers on GD were searched in Korean Medical Journals to Feb. 1988. RESULTS: Review of data obtained from questionnaire survey and literature search yielded a total of 44 pts. in 31 pedigrees. 33 of them were reported as type I(chronic, non- neuronopathic), 6 pts. as type II(acute, neuronopathic) and 5 pts. as type III(subacute, neuronopathic). As for the most common type I pts, all 33 but one were diagnosed in infancy and childhood(7mon~18y.o), 11 of them died during childhood(1yr~18y.o), 10 pts. were not known whether alive or dead and 12 pts. are alive and followed up. All 6 type II pts. were diagnosed during infancy and 4 of them died before age of two. All 5 type III pts. in 2 families developed myoclonic seizures in late teens and two died in early twenties and three of them being followed up by neurologists. CONCLUSION: A total of 44 GD pts. in 31 Korean families are identified, which is consistant with autosomal recessive mode of inheritance pattern in all three clinical phenotypes. As of Feb. 1988, 18 pts. were registered in Korean Gaucher Registry; 12 type I pts, 2 type II pts. and 4 type III pts. In case of type I pts., early onset in younger age and rapid progression of disease resulted in high mortality and morbidity compare to GD pts. among Caucasian esp. the most prevalent Ashkenazi Jewish population. Therefore, early diagnosis and effective treatment with Enzyme Replacement Therapy will be desirable for better management of Korean GD pts.
Adolescent ; Early Diagnosis ; Enzyme Replacement Therapy ; Gaucher Disease* ; Humans ; Incidence ; Inheritance Patterns ; Korea ; Mortality ; Natural History ; Phenotype ; Surveys and Questionnaires ; Seizures

Pompe disease, also called type II glycogen storage disease, is a rare autosomal recessive inherited disease caused by the storage of glycogen in lysosome due to acid α-glucosidase (GAA) deficiency, with the most severe conditions in the skeletal muscle, the myocardium, and the smooth muscle. Patients may have the manifestations of dyspnea and dyskinesia, with or without hypertrophic cardiomyopathy. GAA gene mutation has ethnic and regional differences, and new mutation sites are found with the advances in research. Gene analysis is the gold standard for the diagnosis of Pompe disease. Conventional methods, such as skin and muscle biopsies and dried blood spot test, have certain limitations for the diagnosis of this disease. In recent years, prenatal diagnosis and newborn screening play an important role in early diagnosis of this disease. Enzyme replacement therapy (ERT) has a satisfactory effect in the treatment of this disease, but it may lead to immune intolerance. New targeted gene therapy and modified ERT will be put into practice in the future. This article reviews the research advances in the diagnosis and treatment of Pompe disease.
Animals ; Enzyme Replacement Therapy ; Glycogen Storage Disease Type II ; diagnosis ; enzymology ; genetics ; therapy ; Humans ; Targeted Gene Repair ; alpha-Glucosidases ; genetics ; metabolism