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Published on: November 25, 2017
Mental retardation in mucopolysaccharidoses correlates with high molecular weight urinary heparan sulphate derived
G V Coppa1, O Gabrielli1, L Zampini1
1Pediatric Division, Department of Clinical Sciences, Polytechnic University of the Marche, Ospedali Riuniti, Presidio Salesi, Ancona, Italy.
Abstract:
Mucopolysaccharidoses (MPS) are characterized by mental retardation constantly present in the severe forms of Hurler (MPS I), Hunter (MPS II) and Sanfilippo (MPS III) diseases. On the contrary, mental retardation is absent in Morquio (MPS IV) and Maroteaux-Lamy (MPS VI) diseases and absent or only minimal in the attenuated forms of MPS I, II and III. Considering that MPS patients affected by mental disease accumulate heparan sulfate (HS) due to specific enzymatic defects, we hypothesized a possible correlation between urinary HS-derived glucosamine (GlcN) accumulated in tissues and excreted in biological fluids and mental retardation. 83 healthy subjects were found to excrete HS in the form of fragments due to the activity of catabolic enzymes that are absent or impaired in MPS patients. On the contrary, urinary HS in 44 patients was observed to be composed of high molecular weight polymer and fragments of various lengths depending on MPS types. On this basis we correlated mental retardation with GlcN belonging to high and low molecular weight HS. We demonstrate a positive relationship between the accumulation of high molecular weight HS and mental retardation in MPS severe compared to attenuated forms. This is also supported by the consideration that accumulation of other GAGs different from HS, as in MPS IV and MPS VI, and low molecular weight HS fragments do not impact on central nervous system disease.
Insights
Severe mucopolysaccharidoses (MPS) with high molecular weight heparan sulfate (HS) accumulation correlate with mental retardation. Low molecular weight HS fragments and other GAGs do not impact cognitive function in MPS patients.
Area of Science:
- Biochemistry
- Genetics
- Neurology
Background:
- Mucopolysaccharidoses (MPS) are a group of genetic disorders characterized by the accumulation of glycosaminoglycans (GAGs).
- Mental retardation is a common feature in severe forms of MPS I, II, and III, but absent in MPS IV and VI.
- Heparan sulfate (HS) accumulation is linked to cognitive impairment in affected MPS patients.
Purpose of the Study:
- To investigate the correlation between urinary HS-derived glucosamine (GlcN) levels and mental retardation in MPS patients.
- To determine if the molecular weight of accumulated HS fragments influences cognitive outcomes.
Main Methods:
- Analysis of urinary HS composition (high vs. low molecular weight) in 44 MPS patients and 83 healthy controls.
- Correlation of HS-GlcN levels and molecular weight with the presence and severity of mental retardation.
Main Results:
- Healthy individuals excrete low molecular weight HS fragments.
- MPS patients excrete high molecular weight HS polymers and fragments of varying lengths.
- A positive correlation was found between high molecular weight HS accumulation and mental retardation in severe MPS forms.
Conclusions:
- High molecular weight HS accumulation is associated with mental retardation in MPS.
- Low molecular weight HS fragments and other GAGs do not appear to affect central nervous system development in MPS.
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