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2013 ; 6
(4
): 186-193
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Enzymatic Screening and Diagnosis of Lysosomal Storage Diseases
#MMPMID27293520
Yu C
; Sun Q
; Zhou H
N Am J Med Sci (Boston)
2013[]; 6
(4
): 186-193
PMID27293520
show ga
Lysosomal storage diseases (LSDs) are a group of more than 50 genetic disorders.
Clinical symptoms are caused by the deficiency of specific enzyme (enzymes)
function and resultant substrate accumulation in the lysosomes, which leads to
impaired cellular function and progressive tissue and organ dysfunction.
Measurement of lysosomal enzyme activity plays an important role in the clinical
diagnosis of LSDs. The major enzymatic testing methods include fluorometric
assays using artificial 4-methylumbelliferyl (4-MU) substrates,
spectrophotometric assays and radioactive assays with radiolabeled natural
substrates. As many effective treatment options have become available,
presymptomatic diagnosis and early intervention are imperative. Many methods were
developed in the past decade for newborn screening (NBS) of selective LSDs in
dried blood spot (DBS) specimens. Modified fluorometric assays with 4-MU
substrates, MS/MS or LC-MS/MS multiplex enzyme assays, digital microfluidic
fluorometric assays, and immune-quantification assays for enzyme contents have
been reported in NBS of LSDs, each with its own advantages and limitations.
Active technical validation studies and pilot screening studies have been
conducted or are ongoing. These studies have provided insight in the efficacy of
various methodologies. In this review, technical aspects of the enzyme assays
used in clinical diagnosis and NBS are summarized. The important findings from
pilot NBS studies are also reviewed.