Health Related Quality of Life, Disability, and Pain in Alpha Mannosidosis: Long-Term Data of Enzyme Replacement Therapy With Velmanase Alfa (Human Recombinant Alpha Mannosidase)

Abstract Alpha-mannosidosis, a rare lysosomal storage disorder caused by deficiency of the lysosomal enzyme alpha-mannosidase, results in accumulation of mannose-rich glycoproteins in the tissues and sequelae leading to intellectual disability, ataxia, impaired hearing and speech, recurrent infections, skeletal abnormalities, muscular pain, and weakness. This study aimed to investigate disability, pain, and overall health using the Childhood Health Assessment Questionnaire (CHAQ) and the EuroQol 5 Dimension-5 Level Questionnaire (EQ-5D-5L) in patients with alpha-mannosidosis participating in rhLAMAN-10, a phase III open-label, clinical trial of velmanase alfa, a recombinanthumanlysosomalalpha-mannosidase. Long-termprognosesformost patients withuntreatedalpha-mannosidosisarepoor due to progressive neuromuscular, skeletal, and intellectual deterioration, leading to increased dependence in mobility and activities of daily living and increased caregiver and health-care burden. Long-term CHAQ and EQ-5D-5L data highlight improvement trends in health-related quality of life and a reduction in disability and pain in patients receiving up to 48 months of velmanase alfa treatment.

Intoxicação experimental por Sida carpinifolia (Malvaceae) em bovinos / Experimental poisoning by Sida carpinifolia (Malvaceae) in cattle

Descrevem-se os achados clínicos e patológicos da intoxicação experimental por Sida carpinifolia em bovinos. Para a reprodução experimental da doença, folhas verdes da planta foram coletadas semanalmente na região do Alto Vale do Itajaí e fornecidas in natura diariamente para cinco bovinos nas doses de 10 e 20g/kg por 120 dias, 40g/kg por 30 dias, e 30 e 40g/kg de peso animal por 150 dias. Um bovino morreu e os outros foram eutanasiados ao final do período de consumo da planta. Os principais sinais clínicos consistiam de andar em marcha, olhar atento e tremores de cabeça e foram de intensidade leve a acentuado conforme a dose de planta e tempo de consumo. A lesão histológica predominante caracterizava-se por vacuolização e tumefação de neurônios (principalmente os de Purkinje), das células acinares pancreáticas e células foliculares da tireóide. Ultra-estruturalmente verificou-se vacúolos, por vezes, contendo material finamente granular em neurônios, células acinares pancreáticas e células foliculares da tireóide. S. carpinifolia causa doença de depósito lisossomal em bovinos quando consumida por período prolongado, mesmo em pequenas doses.

Clinical and pathological findings of experimental poisoning by Sida carpinifolia in cattle are described. A neurologic disease was observed in cattle on farms of the Alto Vale do Itajaí region of the Brazilian state of Santa Catarina. For the experimental reproduction of the disease, fresh green leaves, weekly harvested in the same region where spontaneous case occurred, were force-fed to five cattle at doses of 10 and 20g/kg for 120 days, 40g/kg for 30 days, and 30 and 40g/kg body weight for 150 days. One animal died and the others were euthanatized at the end of the experiment. Clinical signs and lesions varied from mild to severe in the experimentally poisoned cattle and depended on dose and length of the period of consumption. Main histological and ultrastructural lesions consisted of vacuolation and distension of neuronal perikarya (mainly of Purkinje cells), and of the cytoplasm of acinar pancreatic cells and thyroid follicular cells. It is concluded that ingestion of even small amounts S. carpinifolia for prolonged periods of time cause lisosomal storage disease in cattle.