Abstract
Biomarkers are surrogate markers of disease activity that may be helpful in the confirmation of a diagnosis and in clinical management. Biomarkers are usually chemical entities, ranging from simple metabolites to complex proteins and polynucleotides that can be measured in bodily fluids such as plasma or urine specimens. Metabolite and protein biomarkers have already been identified for the related lysosomal storage disorder Gaucher disease, and are presently used to support clinical decision making. The current status of biomarker identification and application for Fabry disease is described in this chapter. Attention is paid to metabolites (globotriaosylceramide and globotriaosylsphingosine) as well as the ongoing efforts to identify protein biomarkers. Present limitations in biomarkers are described and perspectives for further research are presented.
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References
Desnick RJ, Ioannou YA (2001) α-Galactosidase a deficiency. Fabry disease. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic and molecular bases of inherited disease, 8th edn. McGraw-Hill, New York, pp 3733–3774
Kint JA (1970) Fabry’s disease: alpha-galactosidase deficiency. Science 167(922):1268–1269
Brady RO, Gal AE, Bradley RM, Martensson E, Warshaw AL, Laster L (1967) Enzymatic defect in Fabry’s disease. Ceramidetrihexosidase deficiency. N Engl J Med 276(21):1163–1167
Hamers MN, Westerveld A, Khan M, Tager JM (1977) Characterization of alpha-galactosidase isoenzymes in normal and Fabry human-Chinese Hamster somatic cell hybrids. Hum Genet 36(3):289–297
Bishop DF, Kornreich R, Desnick RJ (1988) Structural organization of the human alpha-galactosidase A gene: further evidence for the absence of a 3’ untranslated region. Proc Natl Acad Sci USA 85(11):3903–3907
Garman SC, Garboczi DN (2004) The molecular defect leading to Fabry disease: structure of human alpha-galactosidase. J Mol Biol 337(2):319–335
Shabbeer J, Yasuda M, Benson SD, Desnick RJ (2006) Fabry disease: identification of 50 novel alpha-galactosidase A mutations causing the classic phenotype and three-dimensional structural analysis of 29 missense mutations. Hum Genomics 2(5):297–309
Mignani R, Morrone A (2009) Is standard GLA gene mutation analysis definitive for the diagnosis of Fabry disease? Kidney Int 75(10):1115–1116
MacDermot KD, Holmes A, Miners AH (2001) Natural history of Fabry disease in affected males and obligate carrier females. J Inherit Metab Dis 24(Suppl 2):13–14
Whybra C, Kampmann C, Willers I et al (2001) Anderson-Fabry disease: clinical manifestations of disease in female heterozygotes. J Inherit Metab Dis 24(7):715–724
Gupta S, Ries M, Kotsopoulos S, Schiffmann R (2005) The relationship of vascular glycolipid storage to clinical manifestations of Fabry disease: a cross-sectional study of a large cohort of clinically affected heterozygous women. Medicine 84:261–268
Deegan PB, Baehner AF, Barba Romero MA et al (2006) Natural history of Fabry disease in females in the Fabry Outcome Survey. J Med Genet 43(4):347–352
Wang RY, Lelis A, Mirocha J, Wilcox WR (2007) Heterozygous Fabry women are not just carriers, but have a significant burden of disease and impaired quality of life. Genet Med 9(1):34–45
Vedder AC, Linthorst GE, van Breemen MJ et al (2007) The Dutch Fabry cohort: diversity of clinical manifestations and Gb3 levels. J Inherit Metab Dis 30(1):68–78
Desnick RJ, Ioannou YA (1996) α-Galactosidase a deficiency: Fabry disease. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic and molecular bases of inherited disease, 6th edn. McGraw-Hill, New York, pp 2741–2784
Branton MH, Schiffmann R, Sabnis SG et al (2002) Natural history of Fabry renal disease: influence of alpha-galactosidase A activity and genetic mutations on clinical course. Medicine (Baltimore) 81(2):122–138
Altarescu G, Moore DF, Schiffmann R (2005) Effect of genetic modifiers on cerebral lesions in Fabry disease. Neurology 64(12):2148–2150
Rohard I, Schaefer E, Kampmann C, Beck M, Gal A (2008 Oct 22) Association between polymorphisms of endothelial nitric oxide synthase gene (NOS3) and left posteriorwall thickness (LPWT) of the heart in Fabry disease. J Inherit Metab Dis (Epub ahead of print)
Sweeley CC, Klionsky B (1963) Fabry’s disease: classification as a sphingolipidosis and partial characterization of a novel glycolipid. J Biol Chem 238:3148–3150
Mårtensson E (1966) Neutral glycolipids of human kidney isolation, identification, and fatty acid composition. Biochim Biophys Acta 116(2):296–308
Wherrett JR, Hakomori SI (1973) Characterization of a blood group B glycolipid, accumulating in the pancreas of a patient with Fabry’s disease. J Biol Chem 24899:3046–3051
Schiffmann R (2009) Fabry disease. Pharmacol Ther 122(1):65–77
Brady RO, Tallman JF, Johnson WG et al (1973) Replacement therapy for inherited enzyme deficiency. Use of purified ceramidetrihexosidase in Fabry’s disease. N Engl J Med 289(1):9–14
Schiffmann R, Kopp JB, Austin HA III et al (2001) Enzyme replacement therapy in Fabry disease: a randomized controlled trial. JAMA 285(21):2743–2749
Eng CM, Guffon N, Wilcox WR et al (2001) Safety and efficacy of recombinant human alpha-galactosidase A—replacement therapy in Fabry’s disease. N Engl J Med 345(1):9–16
Blom D, Speijer D, Linthorst GE, Donker-Koopman WG, Strijland A, Aerts JM (2003) Recombinant enzyme therapy for Fabry disease: absence of editing of human alpha-galactosidase A mRNA. Am J Hum Genet 72(1):23–31
Vedder AC, Linthorst GE, Houge G et al (2007) Treatment of Fabry disease: outcome of a comparative trial with agalsidase alfa or beta at a dose of 0.2Â mg/kg. PLoS ONE 2(7):e598
Mehta A, Ricci R, Widmer U et al (2004) Fabry disease defined: baseline clinical manifestations of 366 patients in the Fabry Outcome Survey. Eur J Clin Invest 34(3):236–242
Eng CM, Fletcher J, Wilcox WR et al (2007) Fabry disease: baseline medical characteristics of a cohort of 1765 males and females in the Fabry Registry. J Inherit Metab Dis 30(2):184–192
Linthorst GE, Poorthuis BJ, Hollak CE (2008) Enzyme activity for determination of presence of Fabry disease in women results in 40% false-negative results. J Am Coll Cardiol 51(21):2082
Froissart R, Guffon N, Vanier MT, Desnick RJ, Maire I (2003) Fabry disease: D313Y is an alpha-galactosidase A sequence variant that causes pseudodeficient activity in plasma. Mol Genet Metab 80(3):307–314
Tan MA, Dean CJ, Hopwood JJ, Meikle PJ (2008) Diagnosis of metachromatic leukodystrophy by immune quantification of arylsulphatase A protein and activity in dried blood spots. Clin Chem 54(11):1925–1927
Beutler E, Grabowski GA (2001) Gaucher disease. In: Scriver CR, Sly WS, Valle D (eds) The metabolic and molecular bases of inherited disease, 8th edn. McGraw-Hill, New York, pp 3635–3668
Brady RO, Kanfer JN, Bradley RM, Shapiro D (1966) Demonstration of a deficiency of glucocerebroside-cleaving enzyme in Gaucher’s disease. J Clin Invest 45:1112–1115
Patrick AD (1965) A deficiency of glucocerebrosidase in Gaucher’s disease. Biochem J 97:17c–18c
Aerts JM, van Weely S, Boot R, Hollak CE, Tager JM (1993) Pathogenesis of lysosomal storage disorders as illustrated by Gaucher disease. J Inherit Met Dis 16:288–291
Boven LA, van Meurs M, Boot RG, Mehta A, Aerts JM, Laman JD (2004) Gaucher cells demonstrate a distinct macrophage phenotype and resemble alternatively activated macrophages. Am J Clin Pathol 122:359–369
Aerts JM, van Breemen MJ, Bussink AP et al (2008b) Biomarkers for lysosomal storage disorders: identification and application as exemplified by chitotriosidase in Gaucher disease. Acta Paediatr Suppl 97(457):7–14
Aerts JM, Hollak CE (1997) Plasma and metabolic abnormalities in Gaucher’s disease. Baillieres Clin. Haematol 10:691–709
Meikle PJ, Whitfield PD, Rozaklis T et al (2008) Plasma lipids are altered in Gaucher disease: biochemical markers to evaluate therapeutic intervention. Blood Cells Mol Dis 40(3):420–427
Ghauharali-van der Vlugt K, Langeveld M, Poppema A et al (2008) Prominent increase in plasma ganglioside GM3 is associated with clinical manifestations of type I Gaucher disease. Clin Chim Acta 389(1–2):109–113
Hein LK, Meikle PJ, Hopwood JJ, Fuller M (2007) Secondary sphingolipid accumulation in a macrophage model of Gaucher disease. Mol Genet Metab 92(4):336–345
Saito M, Rosenberg A (1985) The fate of glucosylceramide (glucocerebroside) in genetically impaired (lysosomal beta-glucosidase deficient) Gaucher disease diploid human fibroblasts. J Biol Chem 260(4):2295–2300
Nilsson O, Svennerholm L (1982) Accumulation of glucosylceramide and glucosylsphingosine (psychosine) in cerebrum and cerebellum in infantile and juvenile Gaucher disease. J Neurochem 39(3):709–718
Aerts JM, Ottenhoff R, Powlson AS et al (2007) Pharmacological inhibition of glucosylceramide synthase enhances insulin sensitivity. Diabetes 56(5):1341–1349
Langeveld M, Ghauharali KJ, Sauerwein HP et al (2008) Type I Gaucher disease, a glycosphingolipid storage disorder, is associated with insulin resistance. J Clin Endocrinol Metab 93(3):845–851
Moran MT, Schofield JP, Hayman AR, Shi GP, Young E, Cox TM (2000) Pathologic gene expression in Gaucher disease: up-regulation of cysteine proteinases including osteoclastic cathepsin K. Blood 96(5):1969–1978
Hollak CE, van Weely S, van Oers MH, Aerts JM (1994) Marked elevation of plasma chitotriosidase activity. A novel hallmark of Gaucher disease. J Clin Invest 93(3):1288–1292
Bussink AP, van Eijk M, Renkema GH, Aerts JM, Boot RG (2006) The biology of the Gaucher cell: the cradle of human chitinases. Int Rev Cytol 252:71–128
Aguilera B, Ghauharali-van der Vlugt K, Helmond MT et al (2003) Transglycosidase activity of chitotriosidase: improved enzymatic assay for the human macrophage chitinase. J Biol Chem 278(42):40911–40916
Schoonhoven A, Rudensky B, Elstein D et al (2007) Monitoring of Gaucher patients with a novel chitotriosidase assay. Clin Chim Acta 381(2):136–139
Boot RG, Renkema GH, Verhoek M et al (1998) The human chitotriosidase gene. Nature of inherited enzyme deficiency. J Biol Chem 273(40):25680–25685
Boot RG, Verhoek M, de Fost M et al (2004) Marked elevation of the chemokine CCL18/PARC in Gaucher disease: a novel surrogate marker for assessing therapeutic intervention. Blood 103(1):33–39
Boot RG, Verhoek M, Langeveld M et al (2006) CCL18: a urinary marker of Gaucher cell burden in Gaucher patients. J Inherit Metab Dis 29(4):564–571
van Breemen MJ, de Fost M, Voerman JS et al (2007) Increased plasma macrophage inflammatory protein (MIP)-1alpha and MIP-1beta levels in type 1 Gaucher disease. Biochim Biophys Acta 1772(7):788–796
van Breemen MJ, Aerts JM, Sprenger RR, Speijer D (2008) Potential artefacts in proteome analysis of plasma of Gaucher patients due to protease abnormalities. Clin Chim Acta 396(1–2):26–32
Smit S, van Breemen MJ, Hoefsloot HC, Smilde AK, Aerts JM, de Koster CG (2007) Assessing the statistical validity of proteomics based biomarkers. Anal Chim Acta 592(2):210–217
Vissers JP, Langridge JI, Aerts JM (2007) Analysis and quantification of diagnostic serum markers and protein signatures for Gaucher disease. Mol Cell Proteomics 6(5):755–766
Hollak CE, Maas M, Aerts JM (2001) Clinically relevant therapeutic endpoints in type I Gaucher disease. J Inherit Metab Dis 24(Suppl 2):97–105
Deegan PB, Moran MT, McFarlane I et al (2005) Clinical evaluation of chemokine and enzymatic biomarkers of Gaucher disease. Blood Cells Mol Dis 35(2):259–267
Desnick RJ, Dawson G, Desnick SJ, Sweeley CC, Krivit W (1971) Diagnosis of glycosphingolipidoses by urinary-sediment analysis. N Engl J Med 284(14):739–744
Mills K, Vellodi A, Morris P et al (2004) Monitoring the clinical and biochemical response to enzyme replacement therapy in three children with Fabry disease. Eur J Pediatr 163(10):595–603
Fauler G, Rechberger GN, Devrnja D et al (2005) Rapid determination of urinary globotriaosylceramide isoform profiles by electrospray ionization mass spectrometry using stearoyl-d35-globotriaosylceramide as internal standard. Rapid Commun Mass Spectrom 19(11):1499–1506
Fuller M, Sharp PC, Rozaklis T et al (2005) Urinary lipid profiling for the identification of Fabry hemizygotes and heterozygotes. Clin Chem 51(4):688–694
Auray-Blais C, Cyr D, Mills K, Giguère R, Drouin R (2007) Development of a filter paper method potentially applicable to mass and high-risk urinary screenings for Fabry disease. J Inherit Metab Dis 30(1):106
Groener JE, Poorthuis BJ, Kuiper S, Helmond MT, Hollak CE, Aerts JM (2007) HPLC for simultaneous quantification of total ceramide, glucosylceramide, and ceramide trihexoside concentrations in plasma. Clin Chem 53(4):742–747
Auray-Blais C, Cyr D, Ntwari A et al (2008) Urinary globotriaosylceramide excretion correlates with the genotype in children and adults with Fabry disease. Mol Genet Metab 93(3):331–340
Young E, Mills K, Morris P et al (2005) Is globotriaosylceramide a useful biomarker in Fabry disease? Acta Paediatr Suppl 94(447):51–54
Whitfield PD, Calvin J, Hogg S et al (2005) Monitoring enzyme replacement therapy in Fabry disease–role of urine globotriaosylceramide. J Inherit Metab Dis 28(1):21–33
Bekri S, Lidove O, Jaussaud R, Knebelmann B, Barbey F (2006) The role of ceramide trihexoside (globotriaosylceramide) in the diagnosis and follow-up of the efficacy of treatment of Fabry disease: a review of the literature. Cardiovasc Hematol Agents Med Chem 4(4):289–297
Popli S, Leehey DJ, Molnar ZV, Nawab ZM, Ing TS (1990) Demonstration of Fabry’s disease deposits in placenta. Am J Obstet Gynecol 162:464–465
Vedder AC, Strijland A, vd Bergh Weerman MA, Florquin S, Aerts JM, Hollak CE (2006) Manifestations of Fabry disease in placental tissue. J Inherit Metab Dis 29(1):106–111
Ohshima T, Murray GJ, Swaim WD et al (1997) alpha-Galactosidase A deficient mice: a model of Fabry disease. Proc Natl Acad Sci USA 94(6):2540–2544
Barbey F, Brakch N, Linhart A et al (2006) Cardiac and vascular hypertrophy in Fabry disease: evidence for a new mechanism independent of blood pressure and glycosphingolipid deposition. Arterioscler Thromb Vasc Biol 26(4):839–844
Boutouyrie P, Laurent S, Laloux B, Lidove O, Grunfeld JP, Germain DP (2002) Arterial remodelling in Fabry disease. Acta Paediatr Suppl 91(439):62–66
Barbey F, Brakch N, Linhart A et al (2006) Increased carotid intima-media thickness in the absence of atherosclerotic plaques in an adult population with Fabry disease. Acta Paediatr Suppl 95(451):63–68
Kalliokoski RJ, Kalliokoski KK, Penttinen M et al (2006) Structural and functional changes in peripheral vasculature of Fabry patients. J Inherit Metab Dis 29(5):660–666
Vedder AC, Gerdes VE, Poorthuis BJ et al (2007) Failure to detect Fabry patients in a cohort of prematurely atherosclerotic males. J Inherit Metab Dis 30(6):988
Aerts JM, Groener JE, Kuiper S et al (2008b) Elevated globotriaosylsphingosine is a hallmark of Fabry disease. Proc Natl Acad Sci USA 105(8):2812–2817
Kaneski CR, Moore DF, Ries M, Zirzow GC, Schiffmann R (2006) Myeloperoxidase predicts risk of vasculopathic events in hemizgygous males with Fabry disease. Neurology 67(11):2045–2047
Vedder AC, Cox-Brinkman J, Hollak CE et al (2006) Plasma chitotriosidase in male Fabry patients: a marker for monitoring lipid-laden macrophages and their correction by enzyme replacement therapy. Mol Genet Metab 89(3):239–244
Shah JS, Hughes DA, Tayebjee MH, MacFadyen RJ, Mehta AB, Elliott PM (2007) Extracellular matrix turnover and disease severity in Anderson-Fabry disease. J Inherit Metab Dis 30(1):88–95
Moore DF, Kaneski CR, Askari H, Schiffmann R (2007) The cerebral vasculopathy of Fabry disease. J Neurol Sci 257(1–2):258–263
DeGraba T, Azhar S, Dignat-George F et al (2000) Profile of endothelial and leukocyte activation in Fabry patients. Ann Neurol 47(2):229–233
Utsumi K, Yamamoto N, Kase R et al (1997) High incidence of thrombosis in Fabry’s disease. Intern Med 36(5):327–329
Shen Y, Bodary PF, Vargas FB et al (2006) Alpha-galactosidase A deficiency leads to increased tissue fibrin deposition and thrombosis in mice homozygous for the factor V Leiden mutation. Stroke 37(4):1106–1108
Eitzman DT, Bodary PF, Shen Y et al (2003) Fabry disease in mice is associated with age-dependent susceptibility to vascular thrombosis. J Am Soc Nephrol 14(2):298–302
Diamantopoulos EJ, Andreadis EA, Vassilopoulos CV, Marakomichelakis GE (2002) Intermittent claudication unmasking underlying Fabry’s disease. Int Angiol 21(2):201–203
Hůlková H, Ledvinová J, Poupĕtová H, Bultas J, Zeman J, Elleder M (1999) [Postmortem diagnosis of Fabry disease in a female heterozygote leading to the detection of undiagnosed manifest disease in the family]. Cas Lek Cesk 138(21):660–664
Schiffmann R, Rapkiewicz A, Abu-Asab M et al (2006) Pathological findings in a patient with Fabry disease who died after 2.5 years of enzyme replacement. Virchows Arch 448(3):337–343
Bodary PF, Shen Y, Vargas FB et al (2005) Alpha-galactosidase A deficiency accelerates atherosclerosis in mice with apolipoprotein E deficiency. Circulation 111(5):629–632
Demuth K, Germain DP (2002) Endothelial markers and homocysteine in patients with classic Fabry disease. Acta Paediatr Suppl 91(439):57–61
Vedder AC, Biró E, Aerts JM, Nieuwland R, Sturk G, Hollak CE (2009) Plasma markers of coagulation and endothelial activation in Fabry disease: impact of renal impairment. Nephrol Dial Transplant 24(10):3074–3081
Moore DF, Krokhin OV, Beavis RC et al (2007) Proteomics of specific treatment-related alterations in Fabry disease: a strategy to identify biological abnormalities. Proc Natl Acad Sci USA 104(8):2873–2878
Vylet’al P, Hůlková H, Zivná M et al (2008) Abnormal expression and processing of uromodulin in Fabry disease reflects tubular cell storage alteration and is reversible by enzyme replacement therapy. J Inherit Metab Dis 31(4):508–517
Linthorst GE, Hollak CE, Donker-Koopman WE, Strijland A, Aerts JM (2004) Enzyme therapy for Fabry disease: neutralizing antibodies toward agalsidase alpha and beta. Kidney Int 66:1589–1595
Ohashi T, Sakuma M, Kitagawa T, Suzuki K, Ishige N, Eto Y (2007) Influence of antibody formation on reduction of globotriaosylceramide (GL-3) in urine from Fabry patients during agalsidase beta therapy. Mol Genet Metab 92(3):271–273
Moore DF, Scott LT, Gladwin MT et al (2001) Regional cerebral hyperperfusion and nitric oxide pathway dysregulation in Fabry disease: reversal by enzyme replacement therapy. Circulation 104(13):1506–1512
Shen JS, Meng XL, Moore DF et al (2008) Globotriaosylceramide induces oxidative stress and up-regulates cell adhesion molecule expression in Fabry disease endothelial cells. Mol Genet Metab 95(3):163–168
Takenaka T, Teraguchi H, Yoshida A et al (2008) Terminal stage cardiac findings in patients with cardiac Fabry disease: an electrocardiographic, echocardiographic, and autopsy study. J Cardiol 51(1):50–59
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Aerts, J.M. (2010). Biomarkers for Fabry Disease. In: Elstein, D., Altarescu, G., Beck, M. (eds) Fabry Disease. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-9033-1_7
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