Sanfilippo Syndrome: Optimizing Care with a Multidisciplinary Approach

Abstract

Zuzanna Cyske,1 Paulina Anikiej-Wiczenbach,2 Karolina Wisniewska,1 Lidia Gaffke,1 Karolina Pierzynowska,1 Arkadiusz Mański,2 Grzegorz Wegrzyn1 1Department of Molecular Biology, Faculty of Biology, University of Gdansk, Gdansk, 80-308, Poland; 2Psychological Counselling Centre of Rare Genetic Diseases, University of Gdansk, Gdansk, 80-309, PolandCorrespondence: Grzegorz Wegrzyn, Department of Molecular Biology, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, Gdańsk, 80-308, Poland, Tel [phone], Fax [phone], Email [email protected]: Sanfilippo syndrome, or mucopolysaccharidosis type III (MPS III), is a disease grouping five genetic disorders, four of them occurring in humans and one known to date only in a mouse model. In every subtype of MPS III (designed A, B, C, D or E), a lack or drastically decreased activity of an enzyme involved in the degradation of heparan sulfate (HS) (a compound from the group of glycosaminoglycans (GAGs)) arises from a genetic defect. This leads to primary accumulation of HS, and secondary storage of other compounds, combined with changes in expressions of hundreds of genes and many defects in organelles and various biochemical processes in the cell. As a result, dysfunctions of tissues and organs occur, leading to severe symptoms in patients. Although changes in somatic organs are considerable, the central nervous system is especially severely affected, and neurological, cognitive and behavioral disorders are the most significant changes, making the disease enormously burdensome for patients and their families. In the light of the current lack of any registered therapy for Sanfilippo syndrome (despite various attempts of many research groups to develop effective treatment, still no specific drug or procedure is available for MPS III), optimizing care with a multidisciplinary approach is crucial for managing this disease and making quality of patients’ life passable. This includes efforts to make/organize (i) accurate diagnosis as early as possible (which is not easy due to various possible misdiagnosis events caused by similarity of MPS III symptoms to those of other diseases and variability of patients), (ii) optimized symptomatic treatment (which is challenging because of complexity of symptoms and often untypical responses of MPS III patients to various drugs), and (iii) psychological care (for both patients and family members and/or caregivers). In this review article, we focus on these approaches, summarizing and discussing them.Keywords: mucopolysaccharidosis type III, accurate diagnosis, symptomatic treatment, psychological care

Keywords

• mucopolysaccharidosis type iii
• accurate diagnosis
• symptomatic treatment
• psychological care