[GM2 gangliosidosis--Tay-Sacks disease and Sandhoff's disease].
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1. Hexosaminidase C has been purified from human placenta. Complete separation from hexosaminidases A and B was achieved. 2. The following properties of hexosaminidase C differ from those of the A and B isozymes. Presence in the supernatant rather than the lysosomes, neutral pH optimum, higher molecular weight, lack of activity on beta-N-acetylgalactosamine derivatives, and lack of immunological relationship. 3. Hexosaminidase C is active in patients deficient in hexosaminidases A and B and can be recognized by its characteristic electrophoretic mobility. It is concluded that the genetic origin of hexosaminidase C is probably different from that of hexosaminidases A and B.
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Hex S, the major residual beta hexosaminidase activity present in tissues, fluids, and cultured skin fibroblasts of patients with type 0 GM2 gangliosidosis, was isolated and characterized biochemically and immunologically. when appropriate tissue homogenates were tested by electrophoresis on cellulose acetate gels, hex S as well as hex C, the corresponding minor beta hexosaminidase component found in normal visceral tissues, migrated with greater anodic mobilities than hex A. However, a small but reproducible electrophoretic difference was observed between partially purified hex S and hex C components. Hex S and hex C had slightly higher apparent molecular weights than those of hex A or hex G; no major differences were found between hex S and hex A in thermostability, pH optimum, or kinetic properties. Hex S, like hex C from placenta, reacted with an antiserum directed towards the unique antigenic determinants alpha of hex A, indicating that hex S, hex C, and hex A share a common antigenic determinant. No reactivity of hex S was detected with an antiserum directed toward the common antigenic determinant beta of hex A and hex B. These results suggest that further biochemical and immunologic characterization of hex S and elucidation of its relationships with hex A, hex B, and hex C may significantly contribute to the understanding of the molecular defects in the GM2 gangliosidoses.
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Serum contains several hexosaminidase forms. Two, HEX A and HEX B, migrate in both DEAE cellulose and isoelectric focussing systems like their tissue counterparts. A major group of serum hexosaminidases migrate in an intermediate position. These forms, collectively named HEX 1, increase during pregnancy and obscure carrier detection for Tay-Sachs and Sandhoff's disease. Using DEAE-cellulose chromatography, HEX A, I, and B, can be clearly separated. In normals, activity ratios of A/B are 4.03 +/- 1.33. During pregnancy the ratio falls slightly to 3.01 +/- 1.08. In Tay-Sachs heterozygotes the ratio is only 1.08 +/- 0.35 and falls during early pregnancy to 0.53 +/- 0.23. In Sandhoff heterozygotes the DEAE chromatograms appear normal with higher than normal A/B ratios but in sera, from both pregnant and nonpregnant carriers, the HEX B and HEX I forms are 50% heat labile. During pregnancy, serum can be used as a reliable source of HEX for heterozygote identification for both Sandhoff's and Tay-Sachs disease.
The dual rAAVrh8-HEXA and rAAVrh8-HEXB vector can restore central nervous system hexosaminidase (Hex) enzyme activity, decrease GM2 levels in cerebrospinal fluid and rescue phenotypic consequences of GM2 gangliosidosis, Tay-Sachs and Sandhoff diseases in animal models following simultaneous bi-thalamic (BiT) injections. Following up on an n = 2 expanded access trial, we initiated a phase 1/2, single-dose, dose-escalation of combined BiT, intra-cisterna magna and intrathecal infusion in children with Tay-Sachs and Sandhoff diseases (six infantile, three juvenile). The BiT injection volume and vector dose were doubled between four cohorts, with the lowest dose matching the earlier expanded access trial. Cerebrospinal fluid HexA enzyme activity, serum total Hex activity and GM2 levels showed a dose-dependent biochemical correction of the disease. Serum Hex activity surpassed 40 nmol h-1 ml-1, two times the lower limit of normal, and neuroimaging demonstrated increased fiber tracts. Correction was greatest at 12 weeks, but in decline by 24 weeks postdosing. Infantile patients experienced global clinical stabilization and prolonged oral feeding without aspiration until 3-3.5 years. Seizures had a later onset, were less frequent, less severe and more responsive to anti-convulsant medication. Adverse events were rare in infantile patients, but worsening dystonia was observed in juvenile patients, who were excluded from ongoing enrollment. ClinicalTrials.gov registration: NCT04669535 and NCT06614569 .
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.
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.