title: Enzyme therapy in mannose receptor-null mucopolysaccharidosis VII mice defines roles for the mannose 6-phosphate and mannose receptors.
abstract: Enzyme replacement therapy (ERT) is available for several lysosomal storage diseases. Except for Gaucher disease, for which an enzyme with exposed mannosyl residues targets mannose receptors (MR) on macrophages, ERT targets primarily the mannose 6-phosphate receptor (MPR). Most recombinant lysosomal enzymes contain oligosaccharides with both terminal mannosyl and mannose 6-phosphate residues. Effective MPR-mediated delivery may be compromised by rapid clearance of infused enzyme by the MR on fixed tissue macrophages, especially Kupffer cells. To evaluate the impact of this obstacle to ERT, we introduced the MR-null mutation onto the mucopolysaccharidosis type VII (MPS VII) background and produced doubly deficient MR-/- MPS VII mice. The availability of both MR+/+ and MR-/- mice allowed us to study the effects of eliminating the MR on MR- and MPR-mediated plasma clearance and tissue distribution of infused phosphorylated (P) and nonphosphorylated (NP) forms of human beta-glucuronidase (GUS). In MR+/+ MPS VII mice, the MR clearance system predominated at doses up to 6.4 mg/kg P-GUS. Genetically eliminating the MR slowed plasma clearance of both P- and NP-GUS and enhanced the effectiveness of P-GUS in clearing storage in kidney, bone, and retina. Saturating the MR clearance system by high doses of enzyme also improved targeting to MPR-containing tissues such as muscle, kidney, heart, and hepatocytes. Although ablating the MR clearance system genetically is not practical clinically, blocking the MR-mediated clearance system with high doses of enzyme is feasible. This approach delivers a larger fraction of enzyme to MPR-expressing tissues, thus enhancing the effectiveness of MPR-targeted ERT.
authors.affiliation: Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA. slyws@slu.edu
authors.forename: William S
authors.initials: WS
authors.lastname: Sly
authors.forename: Carole
authors.initials: C
authors.lastname: Vogler
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Grubb
authors.forename: Beth
authors.initials: B
authors.lastname: Levy
authors.forename: Nancy
authors.initials: N
authors.lastname: Galvin
authors.forename: Yun
authors.initials: Y
authors.lastname: Tan
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nishioka
authors.forename: Shunji
authors.initials: S
authors.lastname: Tomatsu
mesh_terms: D000818:Animals; D005966:Glucuronidase / Q000172:deficiency / Q000235:genetics / Q000378:metabolism / Q000627:therapeutic use*; D037181:Lectins, C-Type / Q000172:deficiency* / Q000235:genetics / Q000502:physiology*; D000090323:Mannose Receptor; D037241:Mannose-Binding Lectins / Q000172:deficiency* / Q000235:genetics / Q000502:physiology*; D008360:Mannosephosphates / Q000378:metabolism*; D051379:Mice; D008810:Mice, Inbred C57BL; D018345:Mice, Knockout; D008822:Mice, Transgenic; D016538:Mucopolysaccharidosis VII / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics*; D010766:Phosphorylation; D017527:Receptor, IGF Type 2 / Q000502:physiology*; D011956:Receptors, Cell Surface / Q000172:deficiency* / Q000235:genetics / Q000502:physiology*
chemical_list: D037181:Lectins, C-Type; D000090323:Mannose Receptor; D037241:Mannose-Binding Lectins; D008360:Mannosephosphates; D017527:Receptor, IGF Type 2; D011956:Receptors, Cell Surface; C027693:mannose-6-phosphate; D005966:Glucuronidase