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In Vitro Enzyme Measurement to Test Pharmacological Chaperone Responsiveness in Fabry and Pompe Disease
Published on: December 20, 2017
Cardiac challenges in patients with Fabry disease
F Weidemann1, A Linhart, L Monserrat
1Department of Medicine I, Center of Cardiovascular Medicine, Würzburg, Germany. weidemann_f@medizin.uni-wuerzburg.de
Insights
Fabry disease, a genetic disorder causing heart problems, requires early diagnosis for effective enzyme replacement therapy (ERT). Identifying Fabry cardiomyopathy in at-risk patients can lead to timely intervention and improved outcomes.
Area of Science:
- Cardiology
- Genetics
- Metabolic Disorders
Background:
- Fabry disease is an X-linked lysosomal storage disorder.
- It is a significant cause of hypertrophic cardiomyopathy (HCM), leading to heart failure and arrhythmias.
- The complex pathophysiology of Fabry cardiomyopathy is not fully understood.
Purpose of the Study:
- To emphasize the importance of early diagnosis for Fabry disease.
- To highlight the role of enzyme replacement therapy (ERT) in managing Fabry cardiomyopathy.
- To promote screening of at-risk cardiology patients for Fabry disease.
Main Methods:
- Enzymatic assays for early detection of Fabry disease.
- Genetic testing to confirm Fabry disease diagnosis.
- Cardiac evaluation of patients with hypertrophic cardiomyopathy (HCM) of unknown origin.
Main Results:
- Early diagnosis of Fabry disease allows for timely intervention with ERT.
- Screening HCM patients may identify undiagnosed Fabry disease cases.
- Identifying affected family members through genetic mapping is possible.
Conclusions:
- Early diagnosis and intervention are crucial for managing Fabry disease and its cardiac manifestations.
- ERT is most effective when initiated before significant cardiac hypertrophy or fibrosis develops.
- Screening selected cardiology patients can improve outcomes for individuals with Fabry disease.
Abstract:
Fabry disease, an X-linked lysosomal storage disorder affecting both men and women, is a relatively prevalent cause of hypertrophic cardiomyopathy (HCM) and is associated with significant morbidity and early death due to heart failure or ventricular arrhythmias. Fabry cardiomyopathy results from progressive build-up of glycosphingolipids in cardiac structures, but the underlying complex pathophysiologic mechanisms remain poorly understood. Disease-specific enzyme replacement therapy (ERT) is available for Fabry disease and, therefore, attention should be focused on early diagnosis of this progressive, life-threatening disease. Selected cardiology patients at high risk for Fabry disease can be tested using simple enzymatic assays, and diagnosis is confirmed by demonstration of a Fabry mutation. Testing cardiology patients with HCM of unknown etiology may identify previously unrecognized Fabry patients and allow genetic mapping to be carried out to identify other affected family members at a relatively early stage of the disease. Timely intervention early on in the disease is a key, as the best responses to ERT are seen in patients with the lowest degree of cardiac hypertrophy and fibrosis at the start of treatment.
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