title: Treatment of lysosomal storage disorders: successes and challenges.
abstract: Treatment options for a number of lysosomal storage disorders have rapidly expanded and currently include enzyme replacement therapy, substrate reduction, chaperone treatment, hematopoietic stem cell transplantation, and gene-therapy. Combination treatments are also explored. Most therapies are not curative but change the phenotypic expression of the disease. The effectiveness of treatment varies considerably between the different diseases, but also between sub-groups of patients with a specific lysosomal storage disorder. The heterogeneity of the patient populations complicates the prediction of benefits of therapy, specifically in patients with milder disease manifestations. In addition, there is a lack of data on the natural history of diseases and disease phenotypes. Initial trial data show benefits on relevant short-term endpoints, but the real world situation may reveal different outcomes. Collaborative international studies are much needed to study the long-term clinical efficacy of treatments, and to detect new complications or associated conditions of the diseases. This review summarizes the available treatment modalities for lysosomal storage disorders and the challenges associated with long term clinical care for these patients.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, SPHINX, Amsterdam Lysosome Center, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, c.e.hollak@amc.nl.
authors.forename: Carla E M
authors.initials: CE
authors.lastname: Hollak
authors.forename: Frits A
authors.initials: FA
authors.lastname: Wijburg
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D056947:Enzyme Replacement Therapy; D015316:Genetic Therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016464:Lysosomal Storage Diseases / Q000628:therapy*; D018832:Molecular Chaperones / Q000627:therapeutic use; D058990:Molecular Targeted Therapy / Q000379:methods; D010166:Palliative Care / Q000379:methods
chemical_list: D000975:Antioxidants; D018832:Molecular Chaperones