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首页> 外文期刊>Neurology: Genetics >Miglustat Therapy for SCARB2-Associated Action Myoclonus–Renal Failure Syndrome
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Miglustat Therapy for SCARB2-Associated Action Myoclonus–Renal Failure Syndrome

机译:瘢痕疙瘩治疗瘢痕疙瘩治疗肌阵挛性 - 肾功能衰竭综合征

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Objective We evaluated whether substrate reduction therapy with miglustat could alter the course of action myoclonus–renal failure syndrome (AMRF), a rare, progressive myoclonic epilepsy with early mortality caused by scavenger receptor class B member 2 (S CARB2 ) gene mutations. Methods We identified an AMRF patient with a biallelic combination of SCARB2 mutations determined by whole exome sequencing. SCARB2 encodes a protein that traffics β-glucocerebrosidase to the lysosomal membrane. Mutations lead to a complex pattern of glucosylceramide accumulation and neurologic symptoms including progressive action myoclonus, seizures, and ataxia. We then evaluated the effect of inhibiting glucosylceramide synthesis, as is used in Gaucher disease. The patient was treated for 3 years with miglustat after several years of steady worsening. Results Progression of myoclonus halted, dysphagia resolved, some skills were reacquired, and seizures remained well controlled. Conclusions The response suggests that neurologic symptoms of SCARB2 -associated AMRF could be ameliorated, at least partly, by targeting glycosphingolipid metabolism with available medications.
机译:目的我们评估含有MIGLUSTAT的基材还原治疗是否可以改变肌阵挛性肾功能衰竭综合征(AMRF),一种罕见的,渐进式肌阵挛性癫痫患者,其具有清除剂受体B成员2(S CARB2)基因突变引起的早期死亡率。方法我们鉴定了具有通过全外壳测序确定的瘢痕2突变的双腿组合的AMRF患者。围巾2编码将β-葡聚糖纤维素酶的蛋白质编码为溶酶体膜。突变导致复杂的葡萄糖胺积累和神经系统症状,包括渐进作用肌阵挛,癫痫发作和共济失调。然后,我们评估了抑制葡萄糖苷酰胺合成的效果,如Gaucher疾病所用。经过几年的稳定恶化后,患者用Miglustat治疗3年。结果肌阵挛的进展停止了,吞咽困难解决,一些技能被重新计入,癫痫发作仍然受到良好的控制。结论反应表明,瘢痕2的神经系统症状可以至少部分地通过靶向可用药物的糖磷脂代谢来改善。

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