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Changes in Glycogen and Glycosaminoglycan Levels in Hepatocytes of Iduronate-2-Sulfatase Knockout Mice before and after Recombinant Iduronate-2-Sulfatase Supplementation

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초록

Purpose: Mucopolysaccharidosis II (MPS II) is a lysosomal storage disorder caused by a deficiency of iduronate-2 sulfatase (IdS), which is involved in the degradation of glycosaminoglycan (GAG). In this study, the frequency of fasting hypoglycemia in patients with MPS II was investigated and changes in accumulation of glycogen and GAG in the hepatocytes of IdS-knockout (KO) mice were evaluated before and after recombinant IdS enzyme replacement therapy (ERT). Materials and Methods: Plasma glucose levels were evaluated after an 8-hour fast in 50 patients with MPS II. The IdS-KO mice were divided into three groups (group 2; saline, group 3; 0.15 mg/kg of IdS, and group 4; 0.5 mg/kg of IdS); wild-type mice were included as controls (group 1). ERT was initiated intravenously at four weeks of age, and continued every week until 20 weeks of age. Results: The mean glucose level after an 8-hour fast was 94.1 ± 23.7 mg/dL in the patients with MPS II. Two (4%) out of 50 patients had fasting hypoglycemia. For the mice, GAG in the lysosomes nearly disappeared and glycogen particles in the cytoplasm were restored to the normal range in group 4. Conclusion: Glucose metabolism in patients with MPS II appeared to function well despite hepatocytic GAG accumulation and hypothetical glycogen depletion. A higher dose of IdS infusion in MPS II mice led to disappearance of lysosomal GAG and restoration of glycogen to the cytoplasm of hepatocytes.

Abstract

Purpose: Mucopolysaccharidosis II (MPS II) is a lysosomal storage disorder caused by a deficiency of iduronate-2 sulfatase (IdS), which is involved in the degradation of glycosaminoglycan (GAG). In this study, the frequency of fasting hypoglycemia in patients with MPS II was investigated and changes in accumulation of glycogen and GAG in the hepatocytes of IdS-knockout (KO) mice were evaluated before and after recombinant IdS enzyme replacement therapy (ERT). Materials and Methods: Plasma glucose levels were evaluated after an 8-hour fast in 50 patients with MPS II. The IdS-KO mice were divided into three groups (group 2; saline, group 3; 0.15 mg/kg of IdS, and group 4; 0.5 mg/kg of IdS); wild-type mice were included as controls (group 1). ERT was initiated intravenously at four weeks of age, and continued every week until 20 weeks of age. Results: The mean glucose level after an 8-hour fast was 94.1 ± 23.7 mg/dL in the patients with MPS II. Two (4%) out of 50 patients had fasting hypoglycemia. For the mice, GAG in the lysosomes nearly disappeared and glycogen particles in the cytoplasm were restored to the normal range in group 4. Conclusion: Glucose metabolism in patients with MPS II appeared to function well despite hepatocytic GAG accumulation and hypothetical glycogen depletion. A higher dose of IdS infusion in MPS II mice led to disappearance of lysosomal GAG and restoration of glycogen to the cytoplasm of hepatocytes.

참고문헌 (10)

  1. Neufeld EF, "The Metabolic and Molecular Bases of Inherited Disease. 8th ed", pp.3421~3452 (2001), McGraw-Hill
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  3. Muenzer J, "A phase II", III clinical study of enzyme replacement therapy with idursulfase in mucopolysaccharidosis II (Hunter syndrome), 2006, pp.8, 465~473
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  5. Garcia AR, "Preclinical dose ranging studies for enzyme replacement therapy with idursulfase in a knock-out mouse model of MPS II", Mol Genet Metab, 91, pp.183~190 (2007)
  6. Huidekoper HH, "Fasting adaptation in idiopathic ketotic hypoglycemia: a mismatch between glucose production and demand", Eur J Pediatr, 167, pp.859~865 (2008)
  7. Sung-Chul Jung, "Characterization of a Novel Mucopolysaccharidosis Type II Mouse Model and Recombinant AAV2", 8 Vector-Mediated Gene Therapy, 2010, pp.30(1), 13~18[DOI]
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  9. Parfrey NA, "Hepatic fibrosis in the mucopolysaccharidoses", Am J Med, 81, pp.825~829 (1986)
  10. Yoshimoto T, "An adult case with Hunter’s syndrome presenting prominent hepatic failure: light and electron microscopic features of the liver", Intern Med, 45, pp.1133~1135 (2006)

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