4.2 Review

Inherited disorders of sulfur amino acid metabolism: recent advances in therapy

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCO.0000000000000705

关键词

dietary therapy; enzyme replacement therapy; homocysteine; inborn errors of metabolism; methionine

资金

  1. Czech Health Research Council [NV19-01-00307]
  2. General University Hospital in Prague [RVO-VFN 64165]
  3. Charles University [Progres Q26]
  4. American Heart Association Scientist Development Grant [16SDG30040000]
  5. HCU Network North America
  6. HCU Network Australia

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The metabolism of sulfur amino acids (SAA) is essential for many cellular functions. Current treatments for genetic disorders of SAA metabolism involve dietary measures and provision of lacking products. Recent studies have identified additional therapeutic targets and explored novel treatments like chaperone and gene therapy.
Purpose of review Metabolism of sulfur amino acids (SAA) provides compounds important for many cellular functions. Inherited disorders of SAA metabolism are typically severe multisystemic diseases affecting brain, liver, connective tissue, or vasculature. The review summarizes the present therapeutic approaches and advances in identifying novel treatment targets, and provides an overview of new therapies. Recent findings Current treatments of genetic disorders of SAA metabolism are primarily based on modulation of affected pathways by dietary measures and provision of lacking products or scavenging of toxic molecules. Recent studies identified additional therapeutic targets distant from the primary defects and explored ideas envisioning novel treatments, such as chaperone and gene therapy. Recombinant protein production and engineering resulted in development and clinical testing of enzyme therapies for cystathionine beta-synthase deficiency, the most common inborn error of SAA metabolism. Complex regulation of pathways involved in SAA metabolism and cellular consequences of genetic defects in SAA metabolism are only partially understood. There is a pressing need to increase substantially our knowledge of the disease mechanisms to develop more effective therapies for patients suffering from these rare disorders.

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