3.9 Article

Niemann-Pick disease: own observations and new therapeutic options

Journal

ORVOSI HETILAP
Volume 162, Issue 2, Pages 74-80

Publisher

AKADEMIAI KIADO ZRT
DOI: 10.1556/650.2021.31950

Keywords

Niemann-Pick disease; acid sphingomyelinase; cholesterol transport protein

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Niemann-Pick disease is an autosomal recessive lysosomal storage disorder caused by enzyme deficiency or protein deficiency, leading to the accumulation of sphingomyelin and cholesterol in cells. Early genetic testing is crucial for diagnosis and treatment, with substrate reduction and enzyme replacement therapies showing promise in alleviating symptoms and slowing disease progression.
The Niemann-Pick disease is an autosomal recessive lysosomal storage disorder caused by the lack or decreased activity of the acid sphingomyelinase enzyme or a deficiency of the Niemann-Pick C intracellular cholesterol transporter protein. As a result of the defect, sphingomyelin and cholesterol accumulate in the lysosomes of the cells. The most common presentation symptom of the disease is abdominal protrusion due to hepatosplenomegaly. The most severe symptoms are the consequences of progressive neurodegeneration. Genetic testing is essential to confirm the diagnosis, which also allows for prenatal genetic testing in the affected families. Early detection of the disease is extremely important as therapeutic options are expanding. Thanks to substrate reduction and enzyme replacement therapies, hepatosplenomegaly can be reduced, and progression of neurological symptoms can be reversed. Through two case reports, the author presents the main types, clinical manifestations, and molecular genetic background of this rare metabolic disorder. The author describes the diagnostic and therapeutic approaches to Niemann-Pick disease.

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