Niemann-Pick Disease Type C: Mutation Spectrum and Novel Sequence Variations in the Human NPC1 Gene.

Niemann-Pick type C (NP-C) is a rare autosomal recessive disorder characterized by storage of unesterified glycolipids and cholesterol in lysosome and/or late endosome due to mutations in either NPC1 or NPC2 gene. This study aims to identify the spectrum of sequence alterations associated to NP-C in individuals with clinical suspicion of this disease. The entire coding region and flanking sequences of both genes associated to NP-C were evaluated in a total of 265 individuals that were referred to our laboratory. Clinical and/or biochemical suspicion of NP-C was confirmed by molecular analysis in 54 subjects. In this cohort, 33 different sequence alterations were identified in NPC1 and one in NPC2. Among those, 5 novel alterations in NPC1 gene were identified as follows: one deletion (p.Lys38_Tyr40del), one frameshift (p.Asn195Lysfs*2), and three missense mutations (p.Cys238Arg, p.Ser365Pro and, p.Val694Met) that are likely to be pathogenic through different approaches, including in silico tools as well as multiple sequence alignment throughout different species. We have also reported main clinical symptoms of patients with novel alterations and distribution of frequent symptoms in the cohort. Findings reported here contribute to the knowledge of mutation spectrum of NP-C, defining frequent mutations as well as novel sequence alterations associated to the disease.

Application of a comprehensive protocol for the identification of Gaucher disease in Brazil.

Gaucher disease (GD) is a sphingolipidosis caused by a genetic defect that leads to glucocerebrosidase (beta-glucosidase) deficiency. Between January 1982 and October 2003, 1,081 blood samples from patients suspected of having GD were referred for biochemical analysis. The activities of the enzymes beta-glucosidase (beta-glu) and chitotriosidase (CT) were measured in these samples. Among the 412 diagnosed cases of GD (38.1%), the great majority were GD type 1. The Brazilian regions with the greatest concentration of these patients were the Southeast, South, and Northeast. The mean age of patients at diagnosis was 19 years. The activity of beta-glu in patients with GD was, on average, 10.7% of that of normal individuals. CT was, on average, 269 times more elevated in this group of patients. Among the 669 cases with no confirmation of GD, there were patients with Niemann-Pick disease types A, B, or C (44 cases), possible heterozygotes for GD (59 cases), patients with other lysosomal storage diseases (LSDs) (19 cases) or with other inborn errors of metabolism (3 cases). In 508 cases, no metabolic disorder was found. This study shows that the biochemical protocol employed was effective for the detection of GD, a disease that is reasonably frequent in Brazil.

Biochemical study on beta-glucosidase in individuals with Gaucher's disease and normal subjects.

BACKGROUND: Gaucher's disease (GD) is a disorder caused by the deficiency of lysosomal beta-glucosidase, an enzyme that participates in the degradation of glycosphingolipids. Deficiency of this enzyme results in the accumulation of glucocerebrosides in macrophage lysosomes. No studies comparing the biochemical and kinetic behavior of this enzyme in leukocytes and fibroblasts from normal individuals and patients with Gaucher's disease are available. METHODS: We compared the activities of beta-glu and chitotriosidase between normal subjects and Gaucher disease patients, and characterized the behavior of beta-glu in terms of pH optimum, heat stability, Km and Vmax. RESULTS: The results showed a different behavior of the enzyme in the groups analyzed. CONCLUSIONS: This finding might be useful in cases in which the measurement of enzyme activity alone is not reliable for the establishment of the diagnosis of Gaucher's disease.

Effect of a peroxysomal proliferator agent on intracellular cholesterol accumulation in cultured fibroblasts from Niemann-Pick type C disease patients.

BACKGROUND: Niemann-Pick type C (NP-C) disease is a lysosomal storage disorder. It is possible that peroxisomes are also modified and their alterations can be an early event in the process of the disease. As the use of peroxisomal inducers restores the original function of the organelle, the importance of peroxisomes is further emphasized and can suggest future therapeutic interventions. METHODS: We treated fibroblast cultures from NP-C patients and normal individuals with 200 and 400 micromol/l clofibrate and evaluated its action on intracellular cholesterol content that was determined by filipin staining and quantitative measurement of unesterified cholesterol. RESULTS: The fibroblasts from NP-C patients that did not receive any drug presented a pattern of intense perinuclear fluorescence associated with the accumulation of unesterified cholesterol which was not observed in normal fibroblasts. Comparing the NP-C fibroblasts that were incubated with clofibrate and the same cells without this treatment, there were no changes in cholesterol content by filipin staining, but normal fibroblasts after incubation with this drug showed a slight increase in its cholesterol content. However, unesterified cholesterol was significantly increased in both cells treated with clofibrate when compared to untreated cells. CONCLUSIONS: Clofibrate is probably not useful for treatment of NP-C patients because it seems to contribute to an increase the cholesterol in the cells of these individuals.