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In Vitro Enzyme Measurement to Test Pharmacological Chaperone Responsiveness in Fabry and Pompe Disease
Published on: December 20, 2017
Immune response hinders therapy for lysosomal storage diseases
1Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA. KPONDER@DOM.WUSTL.EDU
Anti-enzyme antibodies reduce the effectiveness of enzyme replacement therapy (ERT) for mucopolysaccharidosis I (MPS I). Transient immunosuppression can improve enzyme uptake and enhance ERT efficacy in MPS I.
Area of Science:
- Biochemistry
- Immunology
- Genetics
Background:
- Enzyme replacement therapy (ERT) using alpha-L-iduronidase is a treatment for mucopolysaccharidosis I (MPS I).
- Patients with MPS I often develop a significant immune response, including anti-enzyme antibodies, to ERT.
- The impact of these antibodies on ERT efficacy remains largely unknown.
Discussion:
- Dickson et al. show that anti-enzyme antibodies inhibit cellular uptake of alpha-L-iduronidase.
- This inhibition substantially limits the therapeutic efficacy of ERT in canines with MPS I.
- The study highlights the critical role of the immune response in ERT outcomes.
Key Insights:
- Anti-enzyme antibodies directly impede the cellular uptake of therapeutic enzymes.
- The presence of these antibodies significantly compromises the effectiveness of ERT for MPS I.
- Targeting the immune response is crucial for optimizing ERT.
Outlook:
- Transient immunosuppression, achieved through oral administration of cyclosporine A and azathioprine, improved enzyme uptake in MPS I canines.
- This suggests that modulating the immune system at the initiation of ERT could enhance treatment outcomes.
- Further research into transient immunosuppression strategies may improve ERT for various lysosomal storage diseases.
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