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Ganglioside GM2 N-acetyl-beta-D-galactosaminidase and asialo GM2 (GA2) N-acetyl-beta-D-galactosaminidase; studies in human skin fibroblasts.

Ganglioside GM2 and its asialo-derivative, GA2 were radiolabeled in their N-acetyl-D-galactosaminyl moieties by oxidation with galactose oxidase and reduction with tritiated sodium borohydride. Specific activities of 6 X 10(4) dpm/nmol (GM2) and 1.8 X 10(6) dpm/nmol (GA2) were achieved. About 98% of the label was in N-acetyl-D-galactosamine. Using these substrates, an assay was developed for GM2-N-acetyl-beta-D-galactosaminidase (E.C.3.2.1.30) and GA2-N-acetyl-beta-D-galactosaminidase (E.C.3.2.1.30) activities in human cultured skin fibroblasts. The products of the GM2 cleaving reaction were identified as N-acetylgalactosamine and ganglioside GM3. Both GM2 and GA2 cleaving activities were stimulated about 5-fold by purified sodium taurocholate, and this stimulation was inhibited by neutral detergents, lipids and albumin at low concentrations. Addition of various salts, reducing agents and a protein activator factor from human liver of Li et al. (1973) did not stimulate GM2-N-acetyl-beta-D-galactosaminidase activity beyond that found with sodium taurocholate. Under optimal conditions, control fibroblast supernates cleaved ganglioside GM2 at a rate of 3.7 nmol/mg protein/h compared to 1100 for GA2-N-acetyl-beta-D-galactosaminidase and 4700 for 4-methylumbelliferyl-N-acetyl-beta-D-glucosaminidase. Supernates from two patients with Tay-Sachs disease had markedly reduced activity levels for GM2-N-acetyl-beta-D-galactosaminidase but not for the other two substrates. Supernates from two patients with Sandhoff's disease had reduced activities for all three substrates. A supernate from one patient with juvenile GM2 gangliosidosis cleaved GM2 at a somewhat faster rate than those from Tay-Sachs or Sandhoff's patients. Two healthy adult women with markedly reduced hexosaminidase A activities using 4MU-N-acetyl-beta-D-glucosaminide as substrate had approximately half-normal activities using GM2 as substrate. A patient with the Tay-Sachs phenotype but with a partial deficiency of hexosaminidase A using the 4-MU substrate had a profound deficiency using GM2 as substrate. In such unusual hexosaminidase mutants, assays using GM2 as substrate are better indicators of phenotype than those using synthetic substrates.

Adult↗

A study of hexosaminadases in interspecific hybrids and in GM2 gangliosidosis with a discussion on their genetic control.

1. Hexosaminidases were studied by electrophoresis with different human fibroblast extracts. We found in the same conditions of detection and culture three bands from the cathode to the anode, namely Hex B, Hex A, Hex C for the normal fibroblast, Hex B for the two different Tay-Sachs and Hex C for the two unrelated Sandhoff patients. 2. The analysis of man-rodent hybrids (hamster and mouse with normal and Sandhoff human fibroblasts) indicates a probable synteny between MPI, Hex C, "Hex A fast", and "Hex A-like". "Hex A fast" is probably a man-hamster hybrid enzyme, "Hex A-like" a man-mouse enzyme. Our data agree with the model of Ropers and Schwantes (Hex C = (alphaalpha)n; Hex A = (alphabeta)n; Hex B = (betabeta)n). Probably Hex A-fast = (alphabeta')n with hamster Hex B' = (beta'beta')n; and Hex A-like = (alphabeta1)n with mouse Hex B1 = (beta1beta1)n; and probably n = 2 according to the tetrameric structure model of Tallman et al. (1974). 3. As an explanation of the results given by Poenaru et al. (anti Hex A reacts with Hex A and Hex B but not with Hex C) we propose the existence of a compound antigen (alphabeta) for Hex A. Anti Hex A specific = anti (alphabeta); anti Hex A non-specific = anti Hex B = anti B, anti alpha being absent or negligible. 4. In our opinion, the Tay-Sachs mutation opposes the alphaB association while the alphaalpha association is possible at a low rate or unstable; it is thus possible to observe Hex C in certain conditions, e.g. in foetal brain. 5. We present a discussion about the genetic control of hexosaminidases, GM2 gangliosidosis, and the possible localization of the different mutations in the variants.

Animals↗

Substrate reduction therapy for glycosphingolipid storage disorders.

Substrate reduction therapy is a novel approach to treating glycosphingolipid (GSL) lysosomal storage disorders. These diseases are caused by mutations in the genes coding for enzymes involved in GSL catabolism and are characterised by the accumulation of GSL substrates within the lysosomes of cells. The aim of substrate reduction therapy is to inhibit the rate of synthesis of GSLs to levels where the residual activity of the mutant catabolic enzyme is sufficient to prevent pathological storage. In this review we discuss the development of N-butyldeoxynojirimycin (NB-DNJ), an imino sugar that inhibits the ceramide-specific glucosyltransferase which catalyses the first committed step of GSL synthesis. This agent has been shown to slow accumulation of stored glycolipid in an in vitro model of Gaucher's disease and in knockout mouse models of Tay-Sachs and Sandhoff diseases. Furthermore, administration of NB-DNJ to Sandhoff mice delays the onset of neurological disease and also slows its progression. We discuss safety and efficacy data from the clinical trial of substrate reduction with NB-DNJ which has been undertaken in patients with Type 1 Gaucher's disease. This trial provides a proof-of-principle for the use of this approach in a wide range of GSL lysosomal storage diseases.

1-Deoxynojirimycin↗

Variability of localization and intensity of damage of the white matter of the brain and cerebellum in genetically conditioned diseases.

The investigations were based on 3 cases with Leigh, 5 cases with Krabbe's, 4 cases of Alpers, 2 cases with Sandhoff, 1 case with Alexander's disease and 1 case with metachromatic leukodystrophy. In 1 case included into the study we have diagnosed nonketotic hyperglycinemia II. All the diseases under examination are recognized as genetically conditioned or are supposed to be of genetic origin. Damage of the white matter in a more delineated form in certain regions was found in Leigh disease. The changes demonstrated a variable degree of intensity from demyelination to necrosis. More extensive lesions of white matter in gyri and semivoal centrum were found in diseases with simultaneously damaged gray matter e.g. in Alpers and Sandhoff disease. The most extensive changes of diffuse demyelination were found in Krabbe's and Alexander's disease. In these diseases demyelination was accompanied with specific morphological structures e.g. globoidal cells (Krabbe's disease) and Rosenthal fibers (Alexander's disease). The peculiar type of demyelination was characteristic for nonketotic hyperglycinemia of type II. It was expressed by demyelination with vacuolization.

Brain↗

Lipid storage disease: Part III. Ultrastructural evaluation of cultured fibroblasts in sphingolipidoses.

For the purpose of evaluating electron microscopy of tissue culture in making the diagnosis of sphingolipidoses, an ultrastructural study was made on the cultured fibroblasts from 23 patients with the disorders. The characteristic cytoplasmic inclusions were observed in the cultured cells of Fabry disease, Tay-Sachs disease, Sandhoff disease, generalized gangliosidosis, Niemann-Pick disease, metachromatic leukodystrophy, and multiple sulfatase deficiency, and differ in fine structure with these diseases. All these cytoplasmic inclusions were surrounded by a single limiting membrane and enzyme cytochemically showed acid phosphatase activity, indicating their lysosomal origin. Ultrastructurally, the cytoplasmic inclusions showed pleomorphic osmiophilic inclusions in Fabry disease, membranous cytoplasmic bodies (MCB) in Tay-Sachs disease and Sandhoff disease, MCB and vacuolar inclusions containing finely reticulogranular materials in generalized gangliosidosis, myelin-like inclusions in Niemann-Pick disease, concentric lamellar inclusions in metachromatic leukodystrophy, and polymorphic cytoplasmic inclusions in multiple sulfatase deficiency. In the heterozygous carriers of Fabry disease, pleomorphic osmiophilic inclusions were also detected. However, any specific inclusions were not detectable in the cultured fibroblasts of Gaucher disease and Krabbe disease. Availability of electron microscopy in the cultured fibroblasts of sphingolipidoses is discussed.

Acid Phosphatase↗

Mice deficient in all forms of lysosomal beta-hexosaminidase show mucopolysaccharidosis-like pathology.

Lysosomal beta-hexosaminidase consists of 2 subunits, alpha and beta. Mutations in the alpha-subunit gene cause Tay-Sachs disease, while mutations in the beta-subunit gene cause Sandhoff disease. Mice generated by targeted disruption of either the alpha- or beta-subunit genes displayed the pathological features of Tay-Sachs disease or Sandhoff disease, respectively. In this report we describe the pathologic features of mice that carry both disrupted genes and that are deficient in all forms of beta-hexosaminidase activity. These mice displayed physical dysmorphia and extensive neuro-visceral storage. Neurons in the CNS and PNS contained pleomorphic inclusions in addition to membranous cytoplasmic bodies characteristic of gangliosidosis. Diffuse hypomyelination was also apparent in the CNS. Vacuolated cytoplasm was a conspicuous feature of chondrocytes, osteocytes and renal tubular epithelium on routine hematoxylin and eosin (H&E) -stained sections. Numerous vacuolated cells were also noted in the connective tissue, cornea, heart valves, arterial walls, liver, spleen, skin and throughout other visceral organs. These vacuolated cells stained positive with PAS, colloidal iron and alcian blue, indicating an accumulation of glycosaminoglycans. Furthermore, cultured fibroblasts showed a defect in the degradation of glycosaminoglycans, and glycosaminoglycans were excreted in the urine of these mice (1). Thus, morphological and biochemical features in these mice are consistent with those of mucopolysaccharidosis and demonstrate an essential role of beta-hexosaminidase in the degradation of glycosaminoglycans.

Animals↗

[A case of GM-Gangliosidosis (atypical form of the AB variant)].

A case of GM-gangliosidosis, variant AB, with some atypical feautres is reported in a male child, who died at the age of 4 years and 3 months. When he was 2 and a half years old, he showed signs of progressive cerebral disease with increasing motor and mental impairment. The clinical signs suggested a form of neurolipidosis; however the data of the enzymatic activities of the peripheral blood leucocytes did not show any deficit related to these forms. More specifically the values of the exosaminides A and B were normal, although the component A was near the lowest limit of the range. The anatomical, histological, histochemical, ultrastructural and chemical studies showed that it was a form of GM-gangliosidosis with visceral involvement. In the crude lipid extracts of various organs there was not only GM-ganglioside, but also a compound not previously demonstrated in these forms of neurolipidosis. Chemically this compound may be considered a phosphoglyco-lipid-and protein complex. From the enzymatic data in the peripheral blood leucocytes, the case may be a variant AB of the Sandhoff and al. classification (1971). However some clinical signs make our case closer to the 3th type of the O'Brien and al, classification while some histopathological aspects are similar to Tay-Sachs disease (i.e. to the variant B of the Sandhoff et al. classification; i.e. to the 1th type of the O'Brien et al. classification). These data, and the presence of an 'unknown compound', not yet demonstrated in the known forms of GM-gangliosidosis, support the hypothesis that our case may be considered as an 'atypical' form of the variant AB of the gangliosidosis GM and that further studies are necessary to reach a final nosography of these entities.

Brain Chemistry↗

Glycosphingolipid degradation and animal models of GM2-gangliosidoses.

Glycosphingolipids form cell type-specific patterns on the surface of eukaryotic cells. Degradation of glycosphingolipids requires endocytic membrane flow of plasma membrane-derived glycosphingolipids into the lysosomes as the digesting organelles. The inherited deficiencies of lysosomal hydrolases and of sphingolipid activator proteins both give rise to sphingolipid storage diseases. Recent research has focused on the mechanisms leading to selective membrane degradation in the lysosomes and on the mechanism and physiological function of sphingolipid activator proteins. The GM2-degrading system is a paradigm for activator protein-dependent lysosomal degradation. Three polypeptide chains contribute to the in vivo degradation of ganglioside GM2: the alpha- and beta-chains of the beta-hexosaminidases and the GM2 activator. Mouse models of Tay-Sachs disease (alpha-chain deficiency), Sandhoff disease (beta-chain deficiency) and GM2 activator deficiency have been described. While the phenotypes of these variants of GM2-gangliosidoses are only slightly different in humans, the animal models show drastic differences in severity and course of the diseases. The reason for this is the specificity of sialidase, which is different between mouse and human. A double-knockout mouse lacking beta-hexosaminidases A, B and S shows a phenotype of mucopolysaccharidosis and gangliosidosis. A substrate deprivation approach to therapy is discussed with respect to animal models of the GM2-gangliosidoses.

Animals↗

Physiological substrates for human lysosomal beta -hexosaminidase S.

Human lysosomal beta-hexosaminidases remove terminal beta-glycosidically bound N-acetylhexosamine residues from a number of glycoconjugates. Three different isozymes composed of two noncovalently linked subunits alpha and beta exist: Hex A (alphabeta), Hex B (betabeta), and Hex S (alphaalpha). While the role of Hex A and B for the degradation of several anionic and neutral glycoconjugates has been well established, the physiological significance of labile Hex S has remained unclear. However, the striking accumulation of anionic oligosaccharides in double knockout mice totally deficient in hexosaminidase activity but not in mice expressing Hex S (Sango, K., McDonald, M. P., Crawley, J. N., Mack, M. L., Tifft, C.J., Skop, E., Starr, C. M., Hoffmann, A., Sandhoff, K., Suzuki, K., and Proia, R. L., (1996) Nat. Genet. 14, 348-352) prompted us to reinvestigate the substrate specificity of Hex S. To identify physiological substrates of Hex S, anionic and neutral oligosaccharides excreted in the urine of the double knockout mice were isolated and analyzed. Using ESI-MS/MS and glycosidase digestion the anionic glycans were identified as products of incomplete dermatan sulfate degradation whereas the neutral storage oligosaccharides were found to be fragments of N-glycan degradation. In vitro, recombinant Hex S was highly active on water-soluble and amphiphilic glycoconjugates including artificial substrates, sulfated GAG fragments, and the sulfated glycosphingolipid SM2. Hydrolysis of membrane-bound SM2 by the recombinant Hex S was synergistically stimulated by the GM2 activator protein and the lysosomal anionic phospholipid bis(monoacylglycero)phosphate.

Animals↗

A genetic model of substrate deprivation therapy for a glycosphingolipid storage disorder.

Inherited defects in the degradation of glycosphingolipids (GSLs) cause a group of severe diseases known as GSL storage disorders. There are currently no effective treatments for the majority of these disorders. We have explored a new treatment paradigm, substrate deprivation therapy, by constructing a genetic model in mice. Sandhoff's disease mice, which abnormally accumulate GSLs, were bred with mice that were blocked in their synthesis of GSLs. The mice with simultaneous defects in GSL synthesis and degradation no longer accumulated GSLs, had improved neurologic function, and had a much longer life span. However, these mice eventually developed a late-onset neurologic disease because of accumulation of another class of substrate, oligosaccharides. The results support the validity of the substrate deprivation therapy and also highlight some limitations.

Animals↗

A 7-year old white-male boy with progressive neurological deterioration.

A 9-month-old boy presented with rapid deterioration of psychomotor development. He developed seizures at 2 months, and shortly thereafter lost motor skills and developed feeding difficulties, increased startle response, red maculas, and decreased vision. His measurements, including head circumference, were greater than the 95th centile. No organomegaly was found. Serum determination of the hemoxsaminidases confirmed the diagnosis of Sandhoff disease.

Brain↗

Inheritance of the enzyme defect in a new hexosaminidase deficiency disease.

A new form of hexosaminidase deficiency disease is characterized clinically by mild, juvenile-onset, very slowly progressive cerebellar ataxia with macular cherry-red spots and absence of other findings. Biochemically there is striking hexosaminidase deficiency in serum, leukocytes, and fibroblasts. Hexosaminidase B appears absent, but hexosaminidase A-like and S-like activity is present on starch-gel electrophoresis. We studied hexosaminidase in leukocytes and serum from members of an affected patient's family and traced the enzyme defect through four generations. Leukocyte heat-stabile hexosaminidase in obligate and presumptive carriers was depressed both in specific activity (nanomoles per milligram of protein per hour) and as a percentage of total hexosaminidase. The carrier state was expressed in serum, but overlap with controls made this test unreliable. The similarity of these carriers to carriers of Sandhoff disease suggests that the disorders may be closely related, perhaps as allelic mutations of the hexosaminidase beta subunit. Those involve with screening for Tay-Sachs disease should be aware that persons with an increased percentage of hexosaminidase A--that is, a decreased heat-stabile fraction--may be carriers of hexosaminidase deficiency diseases.

Chemical Phenomena↗

Heterozygosity for phosphodiester glycosidase deficiency: a novel human mutation of lysosomal enzyme processing.

We have carried out studies on the fibroblasts of III-3, a clinically normal Lebanese individual previously reported to have abnormally high plasma lysosomal enzyme levels. Mannose-6-phosphate (man-6-P) receptors in III-3 fibroblasts were found to be functioning normally, but the cells had only half normal levels of phosphodiester glycosidase activity. Pinocytosis of III-3 fibroblast secreted beta-hexosaminidase B (hex B) into Sandhoff disease fibroblasts was 18% of control, and the apparent KD for binding of III-3 hex B to man-6-P receptors was 3.7 X 10(-9) M compared to 1.25 X 10(-9) M for control enzyme. Hex B secreted by III-3 fibroblasts included an enzyme pool less electro-negative than control enzyme which had a very low affinity for man-6-P receptors and which did not bind to DEAE-Sephadex. Treatment of this abnormal hex B with exogenous placental phosphodiester glycosidase increased its binding to man-6-P receptors three-fold. Secretion rates of seven lysosomal enzymes from III-3 fibroblasts were, on average, twice as great as rates measured for two I-cell disease heterozygote fibroblast lines. The results suggest that III-3 fibroblasts are heterozygous for phosphodiester glycosidase deficiency. The possibility that an individual homozygous for this enzyme deficiency would develop I-cell disease is discussed.

Carrier Proteins↗

Complementation of genetic disease: a velocity sedimentation procedure for the enrichment of heterokaryons.

Methodology is described to enrich for heterokaryons after mammalian cell fusion. A heterogeneous cell mixture can be separated on a Sta-Put apparatus into fractions of uniform size cells by sedimentation through a 1% bovine serum albumin-5% Ficoll gradient. Unfused RAG and LM/TK- cells, differing by 10% in diameter, have been sorted by size; following fusion, larger and faster sedimenting cells were shown to be hybrids. This methodology can be utilized in genetic complementation studies of human genetic diseases where selection procedures for proliferating hybrids do not exist. When fibroblasts from individuals with Tay-Sachs disease [deficient in hexosaminidase A (HEX A-)] and Sandhoff-Jatzkewitz disease (HEX A- and HEX B-) are fused, HEX A is generated, demonstrating complementation of two different mutations. After Sta-Put fractionation, the HEX A complementation product was associated with the faster sedimenting multinuclear cells and not with the mononuclear parental cells. This methodology will facilitate detection of genetic differences in fibroblasts from related inherited disorders.

Animals↗

Enzyme studies in GM2 gangliosidiosis, and their application in prenatal diagnosis.

Assay of hexosaminidase A and B enzymes in four cases with developmental regression and cherry red spot on fundus examination confirmed that three cases had Tay-Sachs disease, and one case had Sandhoff disease. Prenatal diagnosis was carried out by hexosaminidase enzyme assay in amniotic fluid and cells in one family, and chorionic villus sample in the second family. The fetus was diagnosed to be unaffected in one, and affected in the other family. Assay of hexosaminidase A and B is useful for specific diagnosis of GM2 gangliosidosis, and for prenatal diagnosis to reduce the burden of these disorders.

Biomarkers↗

Purification and some properties of liver and brain beta-N-acetyl-hexosaminidase S.

beta-N-Acetyl-hexosaminidase S (2-acetamido-2-deoxy-beta-hexoside acetamido-deoxyhexohydrolase, EC 3.2.1.52) was purified from liver and brain of a patient deceased of type O GM2 gangliosidosis (Sandhoff's disease). Brain beta-N-acetyl-hexosaminidase S was further purified by preparative polyacrylamide gel electrophoresis. The pH optimum of the purified liver and brain enzyme was 5.0 and Km values were 0.8--0.9 mM and 0.3--0.4 mM with 4-methylumbelliferyl-beta-D-N-acetylglucosamine and beta-D-N-acetylgalactosaminide derivatives, respectively. beta-N-Acetyl-hexosaminidase S was thermolabile losing most of its activity after 50 min at 50 degrees C. The apparent molecular weights of the purified liver and brain enzymes were 154 000 and 152 000, respectively. Hexosamines activated beta-N-acetyl-hexosaminidase S whereas the isoenzyme A and B were inhibited. The glycoprotein nature of beta-N-acetyl-hexosaminidase S was suggested by its affinity towards Concanavalin A-Sepharose.

Binding Sites↗

GM2-ganglioside metabolism in cultured human skin fibroblasts: unambiguous diagnosis of GM2-gangliosidosis.

The metabolism of GM2-ganglioside was studied in situ using cultured skin fibroblasts from normal individuals and patients with different forms of GM2-gangliosidosis. [3H]Sphingosine-labeled GM2 was provided in the culture medium to confluent cells in 6-cm petri dishes. After 10 days, the cells were washed free of radioactivity and harvested by trypsinization. The cellular lipids were extracted and analyzed for radioactivity in GM2 and its metabolic products. In fibroblasts from healthy subjects, 50-60% of the total cellular radioactivity was found in the neutral glycosphingolipids, ceramide, sphingomyelin and fatty acids. Degradation of the labeled GM2 progressed rapidly via GM3, ceramide dihexoside and ceramide monohexoside with a build-up of radioactivity mainly in the ceramide pool of the cell. The labeled ceramide is also reutilized for the synthesis of ceramide trihexoside, globoside and sphingomyelin or is converted to fatty acid and incorporated in ester linkages. In contrast, cells from patients with GM2-gangliosidosis representing Tay-Sachs, Sandhoff and AB variant forms of the disease did not metabolize the ingested labeled GM2-like controls. Nearly all of the radioactivity was present in the ganglioside fraction in the lipid extracts from these cells and consisted of unhydrolyzed GM2. High-performance liquid chromatographic analysis of monosialogangliosides from cells grown without added labeled GM2 in the medium indicated accumulation of endogenously synthesized GM2 in cell lines from all patients with GM2 gangliosidosis compared to healthy controls. This approach provides a reliable tool for pre- and post-natal diagnosis of all forms of GM2-gangliosidosis without ambiguity.

Cells, Cultured↗

A sensitive assay of lysogangliosides using high-performance liquid chromatography.

Lysogangliosides, LGM1, LGM2 and LGM3, each carrying a single sphingoid base (i.e., C18:1, C18:0, C20:1, C20:0), were prepared and a sensitive assay method of these lipids using HPLC was developed. The method involves fluorescence derivatization of the free amino group of the molecule with o-phthalaldehyde, separation of the molecular species of each lysoganglioside using reversed-phase HPLC and assay on the basis of a known amount of one of the lysogangliosides, as the internal standard. Using this method, lysoganglioside can be accurately assayed in the range of 5-1000 pmol. For assay of the lipid in the tissue, crude isolation procedures including extraction of lipids, Folch's partition and DEAE-Sepharose and AG 1-X2 column chromatographies were required before the fluorescence derivatization. In the normal human and the bovine cerebral cortex, 0.4-2.0 pmol/mg protein of LGM1 containing C18:1 and C20:1 sphingosine residues were detected. In the frontal cortex from a patient with Sandhoff disease, an abnormal accumulation (55-78 pmol/mg protein) of LGM2 was noted. Among various molecular species, LGM2 containing C18:1 was the most abundant.

Animals↗