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. 2017 Mar;120(3):247-254.
doi: 10.1016/j.ymgme.2016.12.010. Epub 2016 Dec 22.

Glycosaminoglycan levels in dried blood spots of patients with mucopolysaccharidoses and mucolipidoses

Francyne Kubaski  1 , Yasuyuki Suzuki  2 , Kenji Orii  3 , Roberto Giugliani  4 , Heather J Church  5 , Robert W Mason  6 , Vũ Chí Dũng  7 , Can Thi Bich Ngoc  7 , Seiji Yamaguchi  8 , Hironori Kobayashi  8 , Katta M Girisha  9 , Toshiyuki Fukao  3 , Tadao Orii  3 , Shunji Tomatsu  10
Affiliations

Glycosaminoglycan levels in dried blood spots of patients with mucopolysaccharidoses and mucolipidoses

Francyne Kubaski et al. Mol Genet Metab. 2017 Mar.

Abstract

Mucopolysaccharidoses (MPSs) and mucolipidoses (ML) are groups of lysosomal storage disorders in which lysosomal hydrolases are deficient leading to accumulation of undegraded glycosaminoglycans (GAGs), throughout the body, subsequently resulting in progressive damage to multiple tissues and organs. Assays using tandem mass spectrometry (MS/MS) have been established to measure GAGs in serum or plasma from MPS and ML patients, but few studies were performed to determine whether these assays are sufficiently robust to measure GAG levels in dried blood spots (DBS) of patients with MPS and ML.

Material and methods: In this study, we evaluated GAG levels in DBS samples from 124 MPS and ML patients (MPS I=16; MPS II=21; MPS III=40; MPS IV=32; MPS VI=10; MPS VII=1; ML=4), and compared them with 115 age-matched controls. Disaccharides were produced from polymer GAGs by digestion with chondroitinase B, heparitinase, and keratanase II. Subsequently, dermatan sulfate (DS), heparan sulfate (HS-0S, HS-NS), and keratan sulfate (mono-sulfated KS, di-sulfated KS, and ratio of di-sulfated KS in total KS) were measured by MS/MS.

Results: Untreated patients with MPS I, II, VI, and ML had higher levels of DS compared to control samples. Untreated patients with MPS I, II, III, VI, and ML had higher levels of HS-0S; and untreated patients with MPS II, III and VI and ML had higher levels of HS-NS. Levels of KS were age dependent, so although levels of both mono-sulfated KS and di-sulfated KS were generally higher in patients, particularly for MPS II and MPS IV, age group numbers were not sufficient to determine significance of such changes. However, the ratio of di-sulfated KS in total KS was significantly higher in all MPS patients younger than 5years old, compared to age-matched controls. MPS I and VI patients treated with HSCT had normal levels of DS, and MPS I, VI, and VII treated with ERT or HSCT had normal levels of HS-0S and HS-NS, indicating that both treatments are effective in decreasing blood GAG levels.

Conclusion: Measurement of GAG levels in DBS is useful for diagnosis and potentially for monitoring the therapeutic efficacy in MPS.

Keywords: Glycosaminoglycans; Hematopoietic stem cell transplantation; Mucolipidoses; Mucopolysaccharidoses; Tandem mass spectrometry.

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Conflict of interest statement

Conflict of Interest:

Francyne Kubaski, Yasuyuki Suzuki, Kenji Orii, Roberto Giugliani, Heather J. Church, Robert W. Mason, Vũ Chí Dũng, Can Thi Bich Ngoc, Seiji Yamaguchi, Hironori Kobayashi, Katta M. Girisha, Toshiyuki Fukao, Tadao Orii, and Shunji Tomatsu declare that they have no conflict of interests.

Figures

Figure 1
Figure 1. Dermatan sulfate (DS) levels in treated vs. untreated patients
Untreated patients were compared with controls; treated patients were compared with untreated. Values that were significantly increased in untreated patients or decreased by treatment are marked *p < 0.05; **p < 0.0001
Figure 2
Figure 2. Heparan sulfate (HS-NS and HS-0S) levels in treated vs. untreated patients
Untreated patients were compared with controls; treated patients were compared with untreated. A shows levels of HS-NS and B shows levels of HS-0S as mean and standard deviation. Values that were significantly increased in untreated patients or decreased by treatment are marked *p < 0.05; **p < 0.001
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