[Cases of multiple sulfatase deficiency in sisters--biopsy findings of the sural nerve].
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Biomedical subjects
Publications and source records attributed to R Minami.
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Viral particles morphologically resembling animals caliciviruses in the faeces of a patient with acute gastroenteritis were purified, radiolabeled with [125I], and analyzed by SDS-PAGE. A single major structural protein with a mol. mass 62,000 daltons was identified by immunoprecipitation technique. The finding is consistent with human calicivirus-like particles associated with gastroenteritis being a member of the family Caliciviridae.
Cultured skin fibroblasts from two siblings with multiple sulfatase deficiency (MSD) were assayed for the activities of sulfatases known to degrade acidic glycosaminoglycans (AGAG). There were iduronate sulfatase, arylsulfatase B, heparan sulfate (HS) sulfatase, N-acetylgalactosamine-6-sulfate sulfatase, HS-derived N-acetylglucosamine-6-sulfate sulfatase, and two keratan sulfate (KS)-derived N-acetylglucosamine-6-sulfate sulfatases. The activities of sulfatases required for the degradation of HS were reduced to a greater extent than those for the degradation of dermatan sulfate (DS), and those of sulfatases associated with basic defect of Morquio disease type A were moderately decreased or normal. On the other hand, urinary excretion of AGAG in both patients was increased about 10-fold compared to controls, and especially, the excretion of HS and DS was increased about 150-fold and 50-fold, respectively. Keratan sulfate was not detected. The results suggest that in patients with MSD the degradation of HS might be affected to a greater extent than that of DS.
Chemical structures of keratan sulfate (KS) isolated from the liver affected by Morquio syndrome type A (classical type) were investigated. In the KS from Morquio syndrome liver, the molar ratios of hexose, total sulfate, N-sulfate and sialic acid to hexosamine were 5.07, 0.90, 0.18 and 0.08, respectively, and about 10% of hexosamine consisted of galactosamine. The KS resulted in a production of oligosaccharides of relatively larger size after digestion with keratanase, as compared with bovine corneal KS. These findings strongly suggest that KS accumulated in the liver affected by Morquio syndrome may be derived from bony KS.
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An 11-year-old boy with type 2 GM1-gangliosidosis was presented, providing further evidence for the clinical and biochemical heterogeneity of the disease. The patient had several characteristics of type 2 GM1-gangliosidosis, but was different from so-called typical type 2 GM1-gangliosidosis from the point of view of survival and the degree of GM1-ganglioside accumulation. GM1-gangliosidosis was diagnosed by absence of beta-galactosidase activity in leukocytes and the parents had the enzyme levels of heterozygotes. However, the amount of the brain GM1-ganglioside was accumulated to a less degree in comparison with that of typical type 2 GM1-gangliosidosis, though the activity of GM1-beta-galactosidase in the brain was deficient to the same degree as in the typical case.
The properties of alpha-D-mannosidase in the liver and brain from patients with I-cell disease were investigated, using 4-methylumbelliferyl-alpha-D-mannopyranoside as a substrate. A combination of chromatographies on DEAE-cellulose, concanavalin A-Sepharose and Sephacryl S-300 showed that intermediate alpha-D-mannosidase was present in the liver and brain from I-cell disease as well as control liver and brain, although an abnormal distribution of intermediate and acidic alpha-D-mannosidases occurred in the tissues from I-cell disease. These results suggested that a defect of intermediate alpha-D-mannosidase is unlikely to be the primary defect responsible for I-cell disease.
Acidic glycosaminoglycans (GAGs) and gangliosides were analyzed in the brains from control fetuses, fetal Hurler syndrome, control children and three patients affected by genetic mucopolysaccharidosis (Hurler, Hunter and Morquio syndromes). GAGs contents in the brains from patients with Hurler and Hunter syndromes were approximately 1.5-3.0-fold greater as compared with those controls, and most of the GAGs were much more degraded than those from controls. Dermatan sulfate (DS), which was not identified in the control brains, comprised about 20--40% of the total GAGs. On the other hand, GAGs content and molecular weight distribution in the brain from the patient affected by Morquio syndrome were similar to those in the control brains. GAGs content in the brain from fetal Hurler syndrome was also 2.0-fold greater and DS, which was not detected in the control fetal brains, comprised 1.6% of the total GAGs. However, the molecular weight distribution of the GAGs was similar to those of the control fetal brains. The total amount of the brain gangliosides in all patients assayed here was similar to those in the control brains. However, a greater amount of GM1- and Gm2-gangliosides was observed in the brains from patients with Hurler and Hunter syndromes.
A prenatal diagnosis of Hurler's syndrome was made in a pregnancy at risk in a family with two affected children. The fetus was diagnosed as having Hurler's syndrome on the basis of a deficiency of alpha-L-iduronidase in the cultured amniotic cells. The glycosaminoglycans (GAG) content in the supernatant of the amniotic fluid was increased about 1.5 fold compared with that in the control, and increases of heparan sulfate and dermatan sulfate were observed on electrophoresis. The diagnosis could be confirmed by the deficiencies of alpha-L-iduronidase in the liver and brain from the affected fetus. GAG content in the liver from the affected fetus was increased approximately 10 fold as compared with that in the control fetal liver, and most of the GAG were degraded. The GAG content was observed to be increased two fold in the brain, and dermatan sulfate, which was not detected in normal fetal brain, was identified. beta-Galactosidase activities in the affected liver and brain were decreased to 30-50% of the control, and an altered hexosaminidase A was also observed in the liver.
A case of uridine diphosphate galactose (UDP-Gal) 4-epimerase deficiency was discovered by mass screening of newborn infants. UDP-Gal 4-epimerase activity of red blood cells from the patient was found to be remarkably low, i.e., 7.5% of the level in normal controls at comparable ages. The parents showed intermediate values between those of the patient and controls. The enzyme activity in a specimen of liver tissue obtained from the patient by needle biopsy revealed a normal value. Subsequently, two other families with the condition were found by mass screening and these individuals were found to be heterozygotes.
A patient with vitamin D dependent rickets with decreased sensitivity to 1,25-Dihydroxyvitamin D was observed. She suffered from bone pain of two years duration beginning at 12 years of age and was found to be suffering from hypocalcemia, secondary hyperparathyroidism and osteomalacia. Laboratory findings revealed normal serum 25-hydroxyvitamin D (27 ng/ml) and markedly elevated serum 1,25-dihydroxy-vitamin D (131.9 pg/ml). The hypocalcemia was refractory in spite of administration of 25,000 units of vitamin D2, but therapy with high doses of oral la-hydroxyvitamin D3 resulted in significant elevation of the serum calcium level. The clinical findings and course of the patient's disease were quite different from those of other patients with vitamin D dependent rickets reported by other authors.
Hexosaminidase (Hex) C could be detected in human brains by DEAE cellulose column chromatography, when N-acetyl-beta-D-glucosaminidase activity was determined at pH 5.5. In the chromatographic pattern, the peak of Hex C was always higher than that of Hex A in control prenatal brains and conversely lower in postnatal brains. Hex C was not detected in the brains obtained from two cases of Tay-Sachs disease. In addition, the content of Hex C in the brains of two other Tay-Sachs cases was lower than that of the control. The observation suggests that the absence or reduction of Hex C may have some relation with biochemical defects in Tay-Sachs disease, although Hex C does not share common subunit structures with Hex A and the role of Hex C with respect to GM2-ganglioside degradation remains unknown yet.
Content, composition and molecular weight distribution of acidic glycosaminoglycans (GAGs) were determined in liver from five patients with genetic lysosomal storage diseases (Hurler syndrome, Hunter syndrome of severe type, Morquio syndrome, GM1-gangliosidosis type II and I-cell disease). There was a 30- to 40-fold increase in GAGs content of liver from patients with Hurler and Hunter syndromes. The GAGs accumulated in the livers consisted mainly of heparan sulfate and dermatan sulfate, and had a much lower molecular weight than those from control liver. The major GAG accumulated in liver from Morquio syndrome was keratan sulfate, which was not found in the livers from control and other patients, and chondroitin-6-sulfate was also increased. The content and the composition of liver GAGs from GM1-gangliosidosis and I-cell disease were similar to those of control liver. However, there was about a 33-fold increase in the amount of hexose on the liver GAGs from GM1-gangliosidosis. A molar ratio of sialic acid to hexosamine was 1.35 for the liver GAGs from I-cell disease and that of hexose to hexosamine was 8.47, while they were 0.46 and 2.32, respectively, for the control liver.
Assay conditions were studied for eight lysosomal enzymes in lymphoblastoid cell lines transformed by Epstein-Barr virus. The transformed lymphoblastoid cells retained all eight enzyme activities, though the levels sometimes differed from those in the peripheral lymphocytes or granulocytes. The levels of these eight lysosomal enzymes were measured in lymphoblastoid cells from 11 patients with hereditary lysosomal storage diseases--GMI-gangliosidosis, a variant of beta-galactosidase deficiency (sialidase deficiency with a partial beta-galactosidase deficiency), Tay-Sachs disease, Gaucher disease, Hurler syndrome, Scheie syndrome and I-cell disease--and from 20 of their obligate heterozygotes. No activity of enzymes that were deficient in the respective disease, except I-cell disease, was detected in the lymphoblastoid cells from the patient. In I-cell disease, the cells showed lower levels of some enzyme activities. beta-D-Galactosidase activity from heterozygotes of the patient with GMI-gangliosidosis and alpha-L-iduronidase activity from heterozygotes of the patient with Hurler syndrome were in carrier range. On sephadex G-150 gel filtration, beta-D-galactosidase in control material gave two peaks (I and II). In GMI-gangliosidosis, peak II was absent and peak I was markedly diminished. Peak II in the heterozygotes was smaller than that of control. On DEAE cellulose column chromatography of hexosaminidase, two major isoenzymes (hexosaminidase A and B) were detected in control. However, hexosaminidase A was not detected in Tay-Sachs disease, and the ratios of hexosaminidase (Hex) A/Hex B in the parents were lower than those in control.
The oral loading tests of lysine in 9 healthy men and the intravenous loading tests of lysine, ornithine and arginine in 3 healthy men were carried out. The results indicated that the membrane transport system of citrulline in the human kidney was clearly inhibited by dibasic amino acids, lysine, ornithine, and arginine.
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The urea-synthesizing enzymes of human liver tissues, namely, carbamylphosphate synthetase (CPS, EC 2.7.2.2), ornithine transcarbamylase (OTC, EC 2.1.3.3), arginine synthetase system, argininosuccinase (ASase, EC 4.3.2.1), and arginase (EC 3.5.3.1) were measured between pre- and postnatal periods. Specimens from 67 autopsied human livers obtained from fetuses, premature infants, newborn infants, infants, children, and adults were examined. The mean activities of the enzymes showed an increased pattern for OTC and arginase at fetal life, whereas those of CPS, arginine synthetase system, and ASase of fetal livers showed no significant difference in each stage. Except for arginase, the other four enzyme activities were higher in the postnatal period than those in the fetal life. Arginase activities indicated maximal increase at a gestational age between 28 and 31 weeks and decreased in the postnatal life.
Using 4-methylumbelliferyl-alpha-L-iduronide as a substrate, alpha-L-iduronidase activity was measured in leukocytes and in lymphoblastoid cells obtained from patients with alpha-L-iduronidase deficiency and from obligate heterozygotes for this disease. There was complete discrimination between alpha-L-iduronide in leukocytes and in lymphoblastoid cells from the patients and controls. However, overlap was observed between values of the activity in the obligate heterozygotes and those in the controls. 4-Methylumbelliferyl-alpha-L-iduronidase activity because of greater sensitivity, easier assay procedure and shorter incubation period.