Miglustat-induced intestinal carbohydrate malabsorption is due to the inhibition of α-glucosidases, but not β-galactosidases
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Miglustat is an oral medication that has approved indication for type I Gaucher disease and Niemann pick disease type C. Usually treatment with Miglustat is associated with occurrence of gastrointestinal side effects similar to carbohydrate maldigestion symptoms. Here, we studied the direct influence of Miglustat on the enzymatic function of the major disaccharidases of the intestinal epithelium. Our findings show that an immediate effect of Miglustat is its interference with carbohydrate digestion in the intestinal lumen via reversible inhibition of disaccharidases that cleave α-glycosidically linked carbohydrates. Higher non physiological concentrations of Miglustat can partly affect lactase activity. We further show that the inhibition of the disaccharidases function by Miglustat is mainly competitive and does not occur via alteration of the enzyme folding.
KeywordsGauche Disease Intestinal Lumen Brush Border Membrane Lactase Miglustat
brush border membrane
A Ph.D. scholarship provided by the German Academic Exchange Service (DAAD) to M.A. We thank Heshmat Akbari-Borhani for critical discussion.
Conflict of interest
This study has been supported by Actelion Pharmaceuticals GmbH.
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