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Mucopolysaccharidosis I, II, and VI: Brief review and guidelines for treatment
Authors:Giugliani Roberto  Federhen Andressa  Rojas Maria Verônica Muñoz  Vieira Taiane  Artigalás Osvaldo  Pinto Louise Lapagesse  Azevedo Ana Cecília  Acosta Angelina  Bonfim Carmen  Lourenço Charles Marques  Kim Chong Ae  Horovitz Dafne  Bonfim Denize  Norato Denise  Marinho Diane  Palhares Durval  Santos Emerson Santana  Ribeiro Erlane  Valadares Eugênia  Guarany Fábio  de Lucca Gisele Rosone  Pimentel Helena  de Souza Isabel Neves  Correa Jordão  Fraga José Carlos  Goes José Eduardo  Cabral José Maria  Simionato José  Llerena Juan  Jardim Laura  Giuliani Liane  da Silva Luiz Carlos Santana  Santos Mara L  Moreira Maria Angela
Affiliation:, Rede MPS Brasil Brazil.
Abstract:Mucopolysaccharidoses (MPS) are rare genetic diseases caused by the deficiency of one of the lysosomal enzymes involved in the glycosaminoglycan (GAG) breakdown pathway. This metabolic block leads to the accumulation of GAG in various organs and tissues of the affected patients, resulting in a multisystemic clinical picture, sometimes including cognitive impairment. Until the beginning of the XXI century, treatment was mainly supportive. Bone marrow transplantation improved the natural course of the disease in some types of MPS, but the morbidity and mortality restricted its use to selected cases. The identification of the genes involved, the new molecular biology tools and the availability of animal models made it possible to develop specific enzyme replacement therapies (ERT) for these diseases. At present, a great number of Brazilian medical centers from all regions of the country have experience with ERT for MPS I, II, and VI, acquired not only through patient treatment but also in clinical trials. Taking the three types of MPS together, over 200 patients have been treated with ERT in our country. This document summarizes the experience of the professionals involved, along with the data available in the international literature, bringing together and harmonizing the information available on the management of these severe and progressive diseases, thus disclosing new prospects for Brazilian patients affected by these conditions.
Keywords:mucopolisaccharidoses   Hurler syndrome   Hunter syndrome   Maroteaux-Lamy syndrome   enzyme replacement therapy   treatment guidelines
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