The respiratory neuromuscular system in Pompe disease.

Published

Journal Article (Review)

Pompe disease is due to mutations in the gene encoding the lysosomal enzyme acid α-glucosidase (GAA). Absence of functional GAA typically results in cardiorespiratory failure in the first year; reduced GAA activity is associated with progressive respiratory failure later in life. While skeletal muscle pathology contributes to respiratory insufficiency in Pompe disease, emerging evidence indicates that respiratory neuron dysfunction is also a significant part of dysfunction in motor units. Animal models show profound glycogen accumulation in spinal and medullary respiratory neurons and altered neural activity. Tissues from Pompe patients show central nervous system glycogen accumulation and motoneuron pathology. A neural mechanism raises considerations about the current clinical approach of enzyme replacement since the recombinant protein does not cross the blood-brain-barrier. Indeed, clinical data suggest that enzyme replacement therapy delays symptom progression, but many patients eventually require ventilatory assistance, especially during sleep. We propose that treatments which restore GAA activity to respiratory muscles, neurons and networks will be required to fully correct ventilatory insufficiency in Pompe disease.

Full Text

Duke Authors

Cited Authors

  • Fuller, DD; ElMallah, MK; Smith, BK; Corti, M; Lawson, LA; Falk, DJ; Byrne, BJ

Published Date

  • November 1, 2013

Published In

Volume / Issue

  • 189 / 2

Start / End Page

  • 241 - 249

PubMed ID

  • 23797185

Pubmed Central ID

  • 23797185

Electronic International Standard Serial Number (EISSN)

  • 1878-1519

Digital Object Identifier (DOI)

  • 10.1016/j.resp.2013.06.007

Language

  • eng

Conference Location

  • Netherlands