GemPharmatech takes you to understand the rare disease - Mucopolysaccharidosis

February 29, 2024

Introduction of Mucopolysaccharidosis

Mucopolysaccharidosis (MPS) is a group of complex, progressive lysosomal storage diseases that affect multiple systems. It is caused by a deficiency of enzymes responsible for degrading glycosaminoglycans (GAGs). Mucopolysaccharides are a type of complex linear polysaccharides that are normally decomposed and metabolized within cells. Mucopolysaccharides that cannot be completely degraded will accumulate in lysosomes, which can cause developmental delays, skeletal deformities, facial appearance abnormalities, neurological involvement, cardiac lesions, corneal opacity, and other disease phenotypes.

 

Mucopolysaccharidosis can be classified into 7 major types and 11 subtypes based on different lysosomal enzymes encoded by different genes[1] (Table 1). Except for MPS II, which is X-linked, the rest are inherited in an autosomal recessive manner.


MPS

type

Subtype

Enzyme deficient

Accumulating substance

Gene involved

Inheritance pattern

MIM

Age of onset

Incidence

MPS Ⅰ

ⅠH

α-L-iduronidase

DS, HS

IDUA (4p16.3)

AR

607014

1-

years

1/500,000

-1/150,000

ⅠS

607016

5-13

years

1/100,000

ⅠH/ⅠS

607015

3-7

years

1/500,000-1/150,000

MPS 


Iduronate-2-sulfatase

DS, HS

IDS (Xq28)

XR

309900

1st decade

1/150,000-1/100,000male births

MPS 

A

Heparan-N- sulfatase

HS

SGSH (17q25.3)

AR

252900

2-6 years

1/70,000 live births

B

α- N-acetyl glucosaminidase

HS

NAGLU (17q21)

AR

252920

2-6 years


C

Acetyl-Co-A-α- glucosaminide

HS

HGSNAT (8p11.1)

AR

252930

2-6 years


D

N- acetylglucosamine- 6- sulfatase

HS

GNS (12p14)

AR

252940

2-6 years


MPS Ⅳ

ⅣA

N- acetylglucosamine- 6- sulfatase

KS, CS

GALNS (16q24.3)

AR

253000

After 1 year

1/200,000 live births

ⅣB

β- galactosidase

KS

GLBI (3p21.33)

AR

253010

After 1 year


MPS Ⅵ


N- acetylglucosamine- 4- sulfatase

DS, CS

ARSB (5q11-q13)

AR

253200

2 years

1/600,000-1/250,000live births

MPS Ⅶ


β- glucuronidase

HS, DS

GUSB (7q21.11)

AR

253222

Variable

1/250,000 live births

MPS Ⅸ


Hyaluronidase

HA

HYAL1 (3p21.3- p21.2)

AR

601492

Unknown

/rare

Unknown


HS, Heparan sulphate;DS, Dermatan sulphate;CS, Chondroitin sulphate;KS, Keratan Sulfate,;HAhyaluronic acid;AR,Autosomal recessive;XR, X-linked recessive.

Table 1 MPS Subtypes

 

Therapeutic development for MPS  

The current treatment methods for MPS patients include enzyme replacement therapy (ERT), hematopoietic stem cell transplantation (HSCT), substrate reduction therapy (SRT), and various surgical procedures. The main commercially available drugs abroad are enzyme replacement therapy drugs, such as Aldurazyme (MPS I), hunterase and elaprase (MPS II), vimizim (MPS IVA), naglazyme (MPS VI), and mepsevii (MPS VII). However, the above therapies are designed to reduce non-neurological symptoms and pain and are not a complete cure. In recent years, gene therapy has been gaining momentum, aiming to achieve a one-time permanent treatment by repairing enzyme defects. Over the past thirty years, emerging research directions and treatment methods for MPS have mainly focused on gene therapy. The preclinical research on gene therapy for MPS has been increasing year by year, and clinical trials of gene therapy for certain types of MPS are underway in the United States, Australia, and some European countries[2-3].

 

GemPharmatech’s MPS mouse models

At present, the development of new drugs for MPS still has enormous potential and relies heavily on the support of suitable animal models. Targeting the pathogenic mechanisms of different subtypes of MPS and their corresponding defective genes, GemPharmatech has constructed numerous MPS mouse models.


Strain number

Strain name

MPS subtype

T013936

Idua-KO

MPS Ⅰ

T011969

Ids-KO

MPS 

T030220

Galns-KO

MPS ⅣA

T033136

Glb1-KO

MPS B

T028778

Naglu-KO

MPS B

T044283

Hgsnat-KO

MPS C

T035799

Gns-KO

MPS D 

T012455

Arsb-KO

MPS Ⅵ

T023773

Gusb-flox

MPS Ⅶ 

T043993

Sgsh-KO

MPS A

Table 2 List of MPS mouse models


Data display of some mouse models:


1.png



Fig.1 The activity of IDUA enzyme showed a significant decrease in the serum of NCG-Idua-W392X mice.


2.png

Fig.2 The activity of IDUA enzyme showed a significant decrease in the liver and heart tissue of NCG-Idua-W392X mice.


3.png

Fig. 3 The GAGs content in the urine of NCG-Idua-W392X mice was higher than that in NCG control mice.


4.png

Fig.4 The GAGs content in the liver and heart tissue of NCG-Idua-W392X mice was higher than that in NCG control mice.

 

Reference

[1] Bhakthaganesh K, et al. Mucopolysaccharidosis. Taiwan J Ophthalmol. 2023;13(4):443-450.

[2] Ago Y, et al. Molecular Mechanisms in Pathophysiology of Mucopolysaccharidosis and Prospects for Innovative Therapy. Int J Mol Sci. 2024;25(2):1113.

[3] Sawamoto K, et al. Gene therapy for Mucopolysaccharidoses. Mol Genet Metab. 2018;123(2):59-68.