title: High-dose enzyme replacement therapy attenuates cerebroventriculomegaly in a mouse model of mucopolysaccharidosis type II.
abstract: The natural progression of the severe form of mucopolysaccharidosis II in children is a rapid decline of neurodevelopmental function with hydrocephalus. Recombinant human iduronate-2-sulfatase enzyme replacement therapy (ERT) under a standard regimen seems to have limited effect. Therefore, we determined whether early, high-dose ERT attenuated ventriculomegaly and histologic abnormalities in the brains of IdS-knockout mice. IdS-knockout mice received saline or recombinant human IdS (0.5/1.0/2.0 mg kg(-1)) intravenously once weekly, starting at 4 weeks of age and continuing until 20 weeks. ERT with 2.0 mg kg(-1), but not 0.5 or 1.0 mg kg(-1), significantly attenuated enlarged ventricles, as confirmed by in vivo 7-teslar brain magnetic resonance image (MRI) at 20 weeks. However, neuronal cytoplasmic vacuolization and morphological alteration in the purkinje cells on brain histology and glycosaminoglycan (GAG) levels in brain homogenates were reduced in mice receiving ERT at lower dose than 2.0 mg kg(-1). Additionally, GAG levels significantly correlated with the percent volume ratio of ventricle to whole brain. These results suggested that high-dose systemic ERT started early in life could be a promising therapeutic modality for improving neurologic dysfunction including ventriculomegaly in children with severe Hunter syndrome.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: So Yoon
authors.initials: SY
authors.lastname: Ahn
authors.forename: Yun Sil
authors.initials: YS
authors.lastname: Chang
authors.forename: Dong Kyung
authors.initials: DK
authors.lastname: Sung
authors.forename: Ah-Ra
authors.initials: AR
authors.lastname: Ko
authors.forename: Chi Hwa
authors.initials: CH
authors.lastname: Kim
authors.forename: Dong Kyeom
authors.initials: DK
authors.lastname: Yoo
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Lim
authors.forename: Young Bae
authors.initials: YB
authors.lastname: Sohn
authors.forename: Dong Kyu
authors.initials: DK
authors.lastname: Jin
authors.forename: Won Soon
authors.initials: WS
authors.lastname: Park
mesh_terms: D000818:Animals; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D056947:Enzyme Replacement Therapy; D006023:Glycoproteins / Q000008:administration & dosage / Q000627:therapeutic use*; D006025:Glycosaminoglycans / Q000032:analysis; D006801:Humans; D006849:Hydrocephalus / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D051379:Mice; D018345:Mice, Knockout; D016532:Mucopolysaccharidosis II / Q000188:drug therapy* / Q000473:pathology
chemical_list: D006023:Glycoproteins; D006025:Glycosaminoglycans; C018322:IDS protein, human