Biochemical and clinical response after umbilical cord blood transplant in a boy with early childhood-onset beta-mannosidosis.

BACKGROUND: Deficiency in the enzyme ß-mannosidase was described over three decades ago. Although rare in occurrence, the presentation of childhood-onset ß-mannosidase deficiency consists of hypotonia in the newborn period followed by global development delay, behavior problems, and intellectual disability. No effective pharmacologic treatments have been available. METHODS: We report 2-year outcomes following the first umbilical cord blood transplant in a 4-year-old boy with early childhood-onset disease. RESULTS: We show restoration of leukocyte ß-mannosidase activity which remained normal at 2 years posttransplant, and a simultaneous increase in plasma ß-mannosidase activity and dramatic decrease in urine-free oligosaccharides were also observed. MRI of the brain remained stable. Neurocognitive evaluation revealed test point gains, although the magnitude of improvement was less than expected for age, causing lower IQ scores that represent a wider developmental gap between the patient and unaffected peers. CONCLUSION: Our findings suggest that hematopoietic cell transplant can correct the biochemical defect in ß-mannosidosis, although preservation of the neurocognitive trajectory may be a challenge.

Effect of cadmium injected in ovo on hatching results and the activity of plasma hydrolytic enzymes in newly hatched chicks.

The aim of the study was to determine the toxicity of cadmium ions in chick embryos, using plasma hydrolytic enzyme as its biomarker. Hatching eggs (n = 300) from Ross 308 broilers were incubated under standard conditions. On day 4 of incubation, 50 µl of saline solution, containing Cd ions at a concentration from 0 (control group) to 24 µg, was injected in ovo into the egg albumen. The results indicate that the administration of cadmium at doses exceeding 1 µg/egg caused a gradual decrease in hatchability, with an LD50 of 3.9 µg/egg. The greatest differences between the groups in the enzymatic activities studied were found for N-acetyl-ß-D-glucosaminidase (NAG), ß-D-mannosidase (ß-MAN) and arylsulphatase (ARYL). Compared to the control group, in the blood serum of chicks from the groups receiving 3, 6 and 12 µg Cd/egg the NAG activity increased by 79, 108 and 54% and ß-MAN activity by 33, 119 and 108%, respectively. Exposure to cadmium at a dose of 1 to 6 µg per egg caused an about 60% increase in ARYL activity while a dose of 12 µg decreased the activity by about 35% below the level observed in the control group. These findings show that cadmium has a similar toxicity mechanism in mammals and birds, which opens the possibility of using NAG activity as a biomarker of the cytotoxic effect of cadmium in birds.

[A procedure for determination of acid mannosidase activities in biological fluids].

A procedure has been developed for simultaneous determination of the activities of alpha-D- and beta-D-mannosidase in the biological fluids from the quantity of free 4-nitrophenol. The latter is released via enzymatic degradation of substrates of 4-nitrophenyl-alpha-D-mannose and 4-nitrophenyl-beta-D-mannose in individual incubation tests.

Plasma lysosomal enzyme activities in congenital disorders of glycosylation, galactosemia and fructosemia.

BACKGROUND: Variable increases in the plasma activity of different lysosomal enzymes have been reported in patients with congenital disorders of glycosylation (CDG). In particular, elevated plasma aspartylglucosaminidase activity (AGA) has been found in the majority of CDG type I patients. We report on the plasma activity of AGA and other lysosomal enzymes in patients with different types of primary and secondary CDG defects. METHODS: AGA, alpha-mannosidase, beta-mannosidase and beta-hexosaminidase activities were assayed in the plasma of patients with CDGI (4CDGIa, 4CDGIx) and CDGIIx (5, all with a combined N- and O-glycosylation defect), classical galactosemia (GALT) (n=3) and hereditary fructose intolerance (HFI) (n=2). RESULTS: Increased AGA and beta-hexosaminidase activities were found in all and 7/8 of the GDGI patients respectively. All enzymic activities were normal in the CDGIIx patients. Elevated AGA and beta-hexosaminidase activity was also seen in GALT and HFI patients before treatment, when transferrin isoelectric focusing (TfIEF) patterns were also abnormal. CONCLUSIONS: Increased AGA plasma activity, although a consistent finding in CDGI patients, is not specific to this group of disorders since it is also observed in untreated cases of GALT and HFI. Furthermore, plasma AGA activity cannot serve as a marker for CDGII disorders. In conjunction with TfIEF it could be used in the follow up of GALT and HFI patients.

Beta-mannosidosis with angiokeratoma corporis diffusum.

Beta-mannosidosis is a lysosomal disorder which is caused by a deficiency of beta-mannosidase. This disorder was first described in goats. Twelve human cases have already been reported. We present the first case in Japan in whom the diagnosis was reached from angiokeratoma corporis diffusum. Futhermore, mental retardation, hearing loss, and renal failure were also detected. Pseudoxanthoma elasticum was also present, but whether it is a complication of beta-mannosidosis or not remains unknown. The activity level of beta-mannosidase in the patient's plasma was only 2% of the normal range, while that in the patient's mother was 40%. We suggest that beta-mannosidosis should be one of the differential diagnoses when lysosomal enzyme disorders are suspected in cases of angiokeratoma corporis diffusum.