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Late-onset Krabbe disease is predominant in Japan and its mutant precursor protein undergoes more effective processing than the infantile-onset form.
[krabbe disease]
Krabbe
disease
is
an
autosomal
recessive
leukodystrophy
caused
by
the
deficiency
of
the
galactocerebrosidase
(
GALC
)
enzyme
.
It
is
pathologically
characterized
by
demyelination
of
the
central
and
peripheral
nervous
systems
by
accumulation
of
galactosylsphingosine
.
To
date
,
more
than
120
mutations
in
the
GALC
gene
have
been
reported
worldwide
and
genotype-phenotype
correlations
have
been
reported
in
some
types
of
mutations
.
In
this
study
,
we
analyzed
22
unreported
Japanese
patients
with
Krabbe
disease
and
summarized
a
total
of
51
Japanese
patients
,
including
29
previously
reported
patients
.
To
elucidate
how
GALC
mutations
impair
enzymatic
activity
,
multiple
disease-causing
mutations
including
common
mutations
and
polymorphisms
were
investigated
for
enzymatic
activity
and
precursor
processing
ability
with
transient
expression
system
.
We
also
performed
3
-
D
enzyme
structure
analysis
to
determine
the
effect
of
each
new
mutation
.
Five
novel
mutations
were
detected
including
one
deletion
c
.
1808
delT
[
p
.
L
603
X
]
,
one
nonsense
mutation
c
.
1023
C
>
G
[
p
.
Y
341
X
]
,
and
three
missense
mutations
c
.
209
T
>
C
[
p
.
L
70
P
]
,
c
.
1054
G
>
A
[
p
.
G
352
R
]
,
and
c
.
1937
G
>
C
[
p
.
G
646
A
]
.
For
the
total
of
51
patients
,
59
%
had
late-onset
forms
of
Krabbe
disease
.
Seven
common
mutations
accounted
for
58
%
of
mutant
alleles
of
patients
with
Krabbe
disease
in
Japan
.
Infantile
-onset
mutations
had
almost
no
enzyme
activity
,
while
late-onset
mutations
had
4
%
-
20
%
of
normal
enzyme
activity
.
The
processing
rate
of
precursor
GALC
protein
to
mature
form
was
slower
for
infantile
-onset
mutations
.
Heat
stability
of
the
mutant
proteins
revealed
that
p
.
G
270
D
was
more
stable
compared
to
the
other
mutations
.
The
constructed
3
D-
model
showed
that
the
residues
for
Krabbe
mutations
were
less
solvent-accessible
and
located
in
the
core
region
of
GALC
protein
.
In
conclusion
,
we
have
demonstrated
that
the
most
common
phenotype
in
Japan
is
the
late-onset
type
,
that
the
enzyme
activity
for
GALC
mutants
is
correlated
with
mutational
severity
,
and
that
the
most
pathogenic
factor
is
due
to
the
processing
rate
from
the
precursor
to
the
mature
protein
.
Diseases
Validation
Diseases presenting
"that the enzyme activity for galc mutants is correlated with mutational severity"
symptom
krabbe disease
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