Therapeutic response to intravenous infusions of glucocerebrosidase in a patient with Gaucher disease.
Enzyme replacement has been under consideration as a therapeutic strategy for patients with Gaucher disease for more than two decades. Previous studies indicated that single injections of purified glucocerebrosidase reduced the amount of storage material in the liver. It was important to determine whether administration of exogenous enzyme on a regular basis would be of clinical benefit. We report here that weekly i.v. infusions of a macrophage-targeted preparation of human placental glucocerebrosidase in a child with type 1 Gaucher disease increased hemoglobin from 6.9 +/- 0.8 g/dl (+/- 1 SD) to 10.2 +/- 0.4 g/dl (+/- 1 SD) over a 20-week period. The platelet count also increased from a pretreatment value of 30,000 +/- 7000/mm3 (+/- 1 SD) to 54,000 +/- 11,000/mm3 (+/- 1 SD). Phagocytic activity in the spleen decreased during the period of enzyme administration, and there was radiographic evidence of skeletal improvement. These observations document objective clinical responses to enzyme supplementation in a patient with a sphingolipid storage disorder.
Barton
N W
NW
Developmental and Metabolic Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892.
Furbish
F S
FS
Murray
G J
GJ
Garfield
M
M
Brady
R O
RO
D001842:Bone and Bones / Q000000981:diagnostic imaging; D002675:Child, Preschool; D005260:Female; D005776:Gaucher Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005959:Glucosidases / Q000627:therapeutic use*; D005962:Glucosylceramidase / Q000008:administration & dosage / Q000302:isolation & purification / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D010920:Placenta / Q000201:enzymology; D010976:Platelet Count / Q000187:drug effects; D011247:Pregnancy; D011859:Radiography; D011877:Radionuclide Imaging; D013154:Spleen / Q000000981:diagnostic imaging; D013671:Technetium Tc 99m Sulfur Colloid
C070292:alglucerase; D013671:Technetium Tc 99m Sulfur Colloid; D005959:Glucosidases; D005962:Glucosylceramidase