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Publication : β2 Agonists enhance the efficacy of simultaneous enzyme replacement therapy in murine Pompe disease.

First Author  Koeberl DD Year  2012
Journal  Mol Genet Metab Volume  105
Issue  2 Pages  221-7
PubMed ID  22154081 Mgi Jnum  J:180309
Mgi Id  MGI:5306084 Doi  10.1016/j.ymgme.2011.11.005
Citation  Koeberl DD, et al. (2012) beta2 Agonists enhance the efficacy of simultaneous enzyme replacement therapy in murine Pompe disease. Mol Genet Metab 105(2):221-7
abstractText  Enzyme replacement therapy (ERT) with recombinant human acid alpha-glucosidase (rhGAA) has improved clinical outcomes in patients with Pompe disease; however, the response of skeletal muscle and the central nervous system to ERT has been attenuated. The poor response of skeletal muscle to ERT has been attributed to the low abundance of the cation-independent mannose-6-phosphate receptor (CI-MPR), which mediates receptor-mediated uptake of rhGAA. Hence the ability of adjunctive therapy with beta2-agonists to increase CI-MPR expression in skeletal muscle was evaluated during ERT in murine Pompe disease with regard to reversal of neuromuscular involvement. Mice with Pompe disease were treated with weekly rhGAA injections (20mg/kg) and a selective beta2-agonist, either albuterol (30mg/l in drinking water) or low-dose clenbuterol (6mg/l in drinking water). Biochemical correction was enhanced by beta2-agonist treatment in both muscle and the cerebellum, indicating that adjunctive therapy could enhance efficacy from ERT in Pompe disease with regard to neuromuscular involvement. Intriguingly, clenbuterol slightly reduced muscle glycogen content independent of CI-MPR expression, as demonstrated in CI-MPR knockout/GAA knockout mice that were otherwise resistant to ERT. Thus, adjunctive therapy with beta2 agonists might improve the efficacy of ERT in Pompe disease and possibly other lysosomal storage disorders through enhancing receptor-mediated uptake of recombinant lysosomal enzymes.
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