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Anderson-Fabry Disease: Developments in Diagnosis and Treatment

Anderson-Fabryjeva bolest: novosti u dijagnostici i liječenju
Authors: Bašić Kes, Vanja; Cesarik, Marijan; Zavoreo, Iris; Madžar, Zrinko; Demarin, Vida;

Anderson-Fabry Disease: Developments in Diagnosis and Treatment

Abstract

Fabrijeva (Anderson-Fabryjeva) bolest je X-vezana recesivna lizosomna bolest nakupljanja koja je posljadica smanjene aktivnosti lizosomske hidrolaze-α-galaktosidaze A (α-gal A), što dovodi do progresivnog nakupljanja globotriaosilceramida (Gb3) u različitim stanicama, u prvom redu endotelnim i glatko-mišićnim stanicama vaskularnih struktura s posljedičnim oštećenjem glavnih organa, uključujući i središnji živčani sustav. Incidencija ove bolesti je 1 na 40.000-60.000 u muškaraca te 1 na 117.000 u općoj populaciji. Prvi simptomi se javljaju već u djetinjstvu ili adolescenciji, a mogu se javiti i u srednjoj dobi (ovisno o razini aktivnosti enzima). Teže komplikacije bolesti javljaju se u bolesnika koji su neprepoznati i kod kojih nije primijenjena enzimska nadomjesna terapija: kožne, bubrežne, srčane i cerebrovaskularne komplikacije koje mogu dovesti do iznenadne smrti. Rano prepoznavanje simptoma bolesti, mjerenje enzimske aktivnosti, koncentracije Gb3 u krvi, mokraći te bioptatu kože, kao i genetska ispitivanja (gen GLA) omogućavaju ranu dijagnozu i uvođenje rane enzimske nadomjesne terapije. Rano uvođenje enzimske nadomjesne terapije prije pojave značajnijih simptoma i komplikacija bolesti može znatno poboljšati ishod liječenja.

Fabry disease (Anderson-Fabry disease) is an X-linked recessive lysosomal storage disorder resulting from deficient activity of lysosomal hydrolase, α-galactosidase A (α-Gal A), which leads to progressive accumulation of globotriaosylceramide (Gb3) in various cells, predominantly endothelial and vascular smooth muscle cells, with clinical manifestations affecting major organs including the central nervous system. The incidence has been estimated to 1 per 40,000-60,000 males and 1 per 117,000 in the general population. Symptoms usually occur during childhood or adolescence, occasionally in middle age (according to the level of the enzyme activity). Life-threatening complications often develop in untreated patients. In classic Fabry disease, they include cutaneous, renal, cardiac and cerebrovascular manifestations that lead to premature death. Early recognition of symptoms, enzyme activity levels, concentration of Gb3 levels in the blood, urine and skin biopsies, as well as genetic testing (GLA gene) enable establishment of early diagnosis and therapeutic intervention with enzyme replacement therapy. Early therapy initiation prior to significant disease manifestations or complications may improve patient outcome.

Country
Croatia
Keywords

therapy, diagnosis, Fabry Disease, Humans, Anderson-Fabry disease, terapija, Anderson-Fabry disease ; diagnosis ; therapy, dijagnostika, Anderson-Fabryjeva bolest

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    popularity
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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Average
Average
Average
Green
Published in a Diamond OA journal