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Updated: Aug 26, 2025

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Published on: July 21, 2021
The use of pharmacological chaperones in rare diseases caused by reduced protein stability
Jon Gil-Martínez1, Ganeko Bernardo-Seisdedos2, José M Mato1,3
1Precision Medicine and Metabolism Laboratory, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), Bizkaia, Spain.
Abstract:
Rare diseases are most often caused by inherited genetic disorders that, after translation, will result in a protein with altered function. Decreased protein stability is the most frequent mechanism associated with a congenital pathogenic missense mutation and it implies the destabilization of the folded conformation in favour of unfolded or misfolded states. In the cellular context and when experimental data is available, a mutant protein with altered thermodynamic stability often also results in impaired homeostasis, with the deleterious accumulation of protein aggregates, metabolites and/or metabolic by-products. In the last decades, a significant effort has enabled the characterization of rare diseases associated to protein stability defects and triggered the development of innovative therapeutic intervention lines, say, the use of pharmacological chaperones to correct the intracellular impaired homeostasis. Here, we review the current knowledge on rare diseases caused by reduced protein stability, paying special attention to the thermodynamic aspects of the protein destabilization, also focusing on some examples where pharmacological chaperones are being tested.
Insights
Rare genetic diseases often stem from mutations causing unstable proteins. This review explores protein destabilization mechanisms and therapeutic strategies like pharmacological chaperones.
Area of Science:
- Biochemistry and Molecular Biology
- Genetics and Genomics
- Pharmacology
Background:
- Rare diseases are frequently caused by inherited genetic mutations leading to altered protein function.
- Decreased protein stability, often due to missense mutations, is a primary mechanism, causing misfolded proteins and cellular dysfunction.
- This can lead to the accumulation of toxic aggregates and impaired cellular homeostasis.
Purpose of the Study:
- To review current knowledge on rare diseases linked to reduced protein stability.
- To highlight the thermodynamic principles underlying protein destabilization in these conditions.
- To discuss the potential of pharmacological chaperones as a therapeutic approach.
Main Methods:
- Literature review of studies on rare diseases and protein stability.
- Analysis of thermodynamic aspects of protein destabilization.
- Examination of case studies involving pharmacological chaperone therapies.
Main Results:
- Identified decreased protein stability as a common pathogenic mechanism in rare genetic disorders.
- Emphasized the link between altered thermodynamic stability and cellular dysfunction.
- Highlighted the emerging role of pharmacological chaperones in correcting protein misfolding and homeostasis.
Conclusions:
- Rare diseases associated with protein instability represent a significant area of research.
- Understanding the thermodynamics of protein destabilization is crucial for developing effective treatments.
- Pharmacological chaperones show promise for treating these debilitating conditions by restoring protein function and cellular balance.
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