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Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement

Fabry disease (FD) is a relatively rare X-linked hereditary disease caused by mutations in the GLA gene that results in deficient α-galactosidase A (α-Gal A) enzyme activity. The disturbed catabolism of the neutral sphingolipids globotriaosylceramide (Gb3) leads to its progressive lysosomal accumula...

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Autores principales: Saeed, Sahrai, Imazio, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Professional Medical Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676584/
https://www.ncbi.nlm.nih.gov/pubmed/36415271
http://dx.doi.org/10.12669/pjms.38.8.7063
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author Saeed, Sahrai
Imazio, Massimo
author_facet Saeed, Sahrai
Imazio, Massimo
author_sort Saeed, Sahrai
collection PubMed
description Fabry disease (FD) is a relatively rare X-linked hereditary disease caused by mutations in the GLA gene that results in deficient α-galactosidase A (α-Gal A) enzyme activity. The disturbed catabolism of the neutral sphingolipids globotriaosylceramide (Gb3) leads to its progressive lysosomal accumulation throughout the body. Multiple organs can be affected. The atypical late-onset cardiac variant is associated with a high burden of cardiac morbidity and mortality. The aim of this work was to present an updated overview of the FD, with focus on cardiovascular manifestations and its management. Enzyme replacement therapy (ERT) is nowadays an established treatment of FD and is recommended as early as possible with or without chaperone therapy (migalastat) to prevent or delay the progression of renal, cardiac, and cerebrovascular complications. It improves quality of life and may further result in decrease in Left ventricular (LV) mass and to some extent LV function recovery. However, LV hypertrophy (LVH) does not always respond well to ERT despite successful Gb3 clearance. Furthermore, its impact on the hard clinical events is uncertain. Some possible reasons for this apparent discrepancy are discussed. ERT may be less effective in patients who have already developed fibrosis or irreversible organ damage. However, other confounding factors may be equally important.
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spelling pubmed-96765842022-11-21 Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement Saeed, Sahrai Imazio, Massimo Pak J Med Sci Review Article Fabry disease (FD) is a relatively rare X-linked hereditary disease caused by mutations in the GLA gene that results in deficient α-galactosidase A (α-Gal A) enzyme activity. The disturbed catabolism of the neutral sphingolipids globotriaosylceramide (Gb3) leads to its progressive lysosomal accumulation throughout the body. Multiple organs can be affected. The atypical late-onset cardiac variant is associated with a high burden of cardiac morbidity and mortality. The aim of this work was to present an updated overview of the FD, with focus on cardiovascular manifestations and its management. Enzyme replacement therapy (ERT) is nowadays an established treatment of FD and is recommended as early as possible with or without chaperone therapy (migalastat) to prevent or delay the progression of renal, cardiac, and cerebrovascular complications. It improves quality of life and may further result in decrease in Left ventricular (LV) mass and to some extent LV function recovery. However, LV hypertrophy (LVH) does not always respond well to ERT despite successful Gb3 clearance. Furthermore, its impact on the hard clinical events is uncertain. Some possible reasons for this apparent discrepancy are discussed. ERT may be less effective in patients who have already developed fibrosis or irreversible organ damage. However, other confounding factors may be equally important. Professional Medical Publications 2022 /pmc/articles/PMC9676584/ /pubmed/36415271 http://dx.doi.org/10.12669/pjms.38.8.7063 Text en Copyright: © Pakistan Journal of Medical Sciences https://creativecommons.org/licenses/by/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0 (https://creativecommons.org/licenses/by/3.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Saeed, Sahrai
Imazio, Massimo
Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement
title Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement
title_full Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement
title_fullStr Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement
title_full_unstemmed Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement
title_short Fabry disease: Definition, Incidence, Clinical presentations and Treatment - Focus on cardiac involvement
title_sort fabry disease: definition, incidence, clinical presentations and treatment - focus on cardiac involvement
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676584/
https://www.ncbi.nlm.nih.gov/pubmed/36415271
http://dx.doi.org/10.12669/pjms.38.8.7063
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