Patients with Gaucher disease display systemic oxidative stress dependent on therapy status.
Gaucher disease is an autosomal recessive metabolic disorder caused by mutations in GBA1, which encodes for the lysosomal hydrolase enzyme, β-glucocerebrosidase. The resulting misfolded protein can trigger endoplasmic reticulum stress and an unfolded protein response within the affected cells. The enzyme deficiency leads to accumulation of its substrates, glucosylceramide and glucosylsphingosine, within macrophage lysosomes and with prominent disease manifestations in macrophage rich tissues. Resultant lysosomal pathology and impaired autophagy leads to redox imbalance, mitochondrial dysfunction and intracellular oxidative stress. Here we have systematically examined a role for oxidative stress in individuals affected by Gaucher disease. We compared multiple oxidative stress biomarkers in plasma and red blood cell samples from patients who are currently untreated, with those who are stable on standard-of-care therapy, and with healthy controls. We found significant differences in key oxidative stress biomarkers in untreated patients compared to healthy control. In treated patients, results generally fell between the controls and the untreated patients. Interestingly, even asymptomatic and minimally symptomatic untreated patients had evidence of significant systemic oxidative stress. We conclude that underlying oxidative stress may contribute to Gaucher disease pathophysiology including long-term adverse outcomes such as Parkinsonism and malignancies. Therapies targeting oxidative stress may prove useful as adjuvant treatments for Gaucher disease and other lysosomal storage disorders.
['Kartha|Reena V|RV|', 'Terluk|Marcia R|MR|', 'Brown|Roland|R|', 'Travis|Abigail|A|', 'Mishra|Usha R|UR|', 'Rudser|Kyle|K|', 'Lau|Heather|H|', 'Jarnes|Jeanine R|JR|', 'Cloyd|James C|JC|', 'Weinreb|Neal J|NJ|']
Gaucher disease Oxidative stress ACE, angiotensin converting enzyme Antioxidants CHITO, chitotriosidase CNS, central nervous system ERT, enzyme replacement therapy GCase, glucocerebrosidase GD, Gaucher disease GD1, Type 1 Gaucher disease GD2, Type 2 Gaucher disease GD3, Type 3 Gaucher disease GPG, Glycine-Proline-Glutamate GPx, glutathione peroxidase GSH, glutathione GSSG, inactive, oxidized form of glutathione Glutathione HPLC, high performance liquid chromatography LC-MS/MS, liquid chromatography-tandem mass spectrometry Lipid peroxidation Lyso-GL1, glucosylsphingosine MDA, malondialdehyde NYU, New York University RBC, red blood cell ROS, reactive oxygen species SOD, superoxide dismutase SRT, substrate reduction therapy TAC, total antioxidant capacity TBARS, thiobarbituric acid reactive substances TRAP, tartrate resistant acid phosphatase UMN, University of Minnesota