Galactosemia future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
Future or Investigational Therapies
The therapeutic modalities currently being explored are:
- Aldose reductase inhibitors[1]: They prevent the conversion of galactose to galactitol, a highly osmotically active substance [2]. It can accumulate in the lens causing cataract[3], in the brain causing cerebral edema and pseudotumor cerebri[4], and also plays a role in cognitive and neurological symptoms of galactosemia[5]. However, the therapy has been investigated only on animal models (rats and dogs) till now[6], and the effect of blocking the polyol pathway is still not exactly known.
- ER stress reducers: ER stress has been shown to contribute to the pathogenesis of galactosemia by altering the chemical signaling, such as the PI3K/Akt pathway[7]. Downregulation of this pathway has been linked to subfertility and cerebellar ataxia[8]. Hence, its reversal by administering molecules that reduce the ER stress might prove beneficial for the brain and reproductive organs.Positive effects of such compounds i.e. the eukaryotic initiation factor 2-alpha inhibitors (salburinal) have already been demonstrated in mice, thus making it a valid potential treatment[9].
References
- ↑ Lou MF, Dickerson JE, Chandler ML, Brazzell RK, York BM (1989). "The prevention of biochemical changes in lens, retina, and nerve of galactosemic dogs by the aldose reductase inhibitor AL01576". J Ocul Pharmacol. 5 (3): 233–40. doi:10.1089/jop.1989.5.233. PMID 2516529.
- ↑ Timson DJ (2020). "Therapies for galactosemia: a patent landscape". Pharm Pat Anal. 9 (2): 45–51. doi:10.4155/ppa-2020-0004. PMID 32314655 Check
|pmid=
value (help). - ↑ Ai Y, Zheng Z, O'Brien-Jenkins A, Bernard DJ, Wynshaw-Boris T, Ning C; et al. (2000). "A mouse model of galactose-induced cataracts". Hum Mol Genet. 9 (12): 1821–7. doi:10.1093/hmg/9.12.1821. PMID 10915771.
- ↑ Berry GT, Hunter JV, Wang Z, Dreha S, Mazur A, Brooks DG; et al. (2001). "In vivo evidence of brain galactitol accumulation in an infant with galactosemia and encephalopathy". J Pediatr. 138 (2): 260–2. doi:10.1067/mpd.2001.110423. PMID 11174626.
- ↑ Kamijo M, Basso M, Cherian PV, Hohman TC, Sima AA (1994). "Galactosemia produces ARI-preventable nodal changes similar to those of diabetic neuropathy". Diabetes Res Clin Pract. 25 (2): 117–29. doi:10.1016/0168-8227(94)90037-x. PMID 7821191.
- ↑ Obrosova I, Faller A, Burgan J, Ostrow E, Williamson JR (1997). "Glycolytic pathway, redox state of NAD(P)-couples and energy metabolism in lens in galactose-fed rats: effect of an aldose reductase inhibitor". Curr Eye Res. 16 (1): 34–43. doi:10.1076/ceyr.16.1.34.5113. PMID 9043821.
- ↑ Slepak TI, Tang M, Slepak VZ, Lai K (2007). "Involvement of endoplasmic reticulum stress in a novel Classic Galactosemia model". Mol Genet Metab. 92 (1–2): 78–87. doi:10.1016/j.ymgme.2007.06.005. PMC 2141683. PMID 17643331.
- ↑ Balakrishnan B, Chen W, Tang M, Huang X, Cakici DD, Siddiqi A; et al. (2016). "Galactose-1 phosphate uridylyltransferase (GalT) gene: A novel positive regulator of the PI3K/Akt signaling pathway in mouse fibroblasts". Biochem Biophys Res Commun. 470 (1): 205–212. doi:10.1016/j.bbrc.2016.01.036. PMC 4728015. PMID 26773505.
- ↑ Balakrishnan B, Nicholas C, Siddiqi A, Chen W, Bales E, Feng M; et al. (2017). "Reversal of aberrant PI3K/Akt signaling by Salubrinal in a GalT-deficient mouse model". Biochim Biophys Acta Mol Basis Dis. 1863 (12): 3286–3293. doi:10.1016/j.bbadis.2017.08.023. PMID 28844959.