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Lysosomal storage diseases: Stem cell-based cell- and gene-therapy.
[fabry disease]
Lysosomal
storage
diseases
(
LSDs
)
are
caused
by
inborn
genetic
defects
and
most
affected
babies
show
pathology
in
the
CNS
.
LSDs
are
caused
by
a
specific
inherited
enzyme
deficiency
that
results
in
accumulation
of
substrates
in
the
lysosomes
,
distension
of
the
organelles
and
subsequent
cellular
malfunction
.
Currently
,
no
effective
treatment
is
available
for
most
of
the
LSDs
,
because
the
blood
?
brain
barrier
bars
entry
of
enzyme
preparations
into
the
brain
.
Treatment
for
LSDs
can
be
divided
into
those
address
symptoms
or
those
address
cause
.
At
present
,
successful
treatments
for
the
LSDs
are
enzyme
replacement
therapy
(
ERT
)
and
cell
therapy
.
ERT
is
most
successful
in
Gaucher
disease
and
has
been
approved
for
Fabry
disease
,
and
mucopolysaccharidosis
I
(
MPS
I
)
.
In
addition
,
ERT
for
Pompe
disease
,
MPS
II
,
MPS
VI
and
MPS
VII
has
been
planned
and
awaiting
approval
for
treatment
.
Limitations
in
ERT
include
need
for
life-
long
treatment
,
development
of
antibodies
,
and
inability
to
cross
blood
brain
barrier
(
BBB
)
resulting
in
failure
to
halt
disease
progression
in
the
brain
.
Transplantation
of
hematopoietic
stem
cells
(
HSCs
)
,
bone
marrow
stem
cells
(
BMSCs
)
and
umbilical
cord
blood
-derived
stem
cells
(
UCBSCs
)
offer
effective
but
limited
efficacy
for
patients
suffering
from
Krabbe
disease
,
MPS
VII
and
adrenal
leukodystrophy
but
in
other
LSDs
they
are
ineffective
.
Intracranial
/
intracerebral
transplantation
of
genetically
modified
stem
cells
as
enzyme
delivery
system
could
bypass
the
BBB
effectively
and
ensure
release
of
therapeutically
beneficial
amount
of
enzymes
to
affected
CNS
lesion
sites
.
For
this
reason
,
stem
cell-based
gene
therapy
is
the
most
effective
treatment
for
LSDs
.
In
mouse
models
of
LSDs
,
genetically
modified
neural
stem
cells
encoding
enzyme
genes
effectively
decreased
lysosomal
storage
,
reduced
pathology
and
extended
life
span
of
animals
.
Cell-based
gene
therapies
for
LSDs
bridge
the
application
of
ERT
and
gene
therapy
and
are
important
direction
to
pursue
in
the
future
.
Diseases
Validation
Diseases presenting
"inborn genetic defects"
symptom
fabry disease
krabbe disease
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