Enzyme replacement therapy in late‐onset Pompe's disease: a three‐year follow‐up

LPF Winkel, JMP Van den Hout… - Annals of …, 2004 - Wiley Online Library
LPF Winkel, JMP Van den Hout, JHJ Kamphoven, JAM Disseldorp, M Remmerswaal…
Annals of neurology, 2004Wiley Online Library
Pompe's disease is an autosomal recessive myopathy. The characteristic lysosomal storage
of glycogen is caused by acid α‐glucosidase deficiency. Patients with late‐onset Pompe's
disease present with progressive muscle weakness also affecting pulmonary function. In
search of a treatment, we investigated the feasibility of enzyme replacement therapy with
recombinant human α‐glucosidase from rabbit milk. Three patients (aged 11, 16, and 32
years) were enrolled in the study. They were all wheelchair‐bound and two of them were …
Abstract
Pompe's disease is an autosomal recessive myopathy. The characteristic lysosomal storage of glycogen is caused by acid α‐glucosidase deficiency. Patients with late‐onset Pompe's disease present with progressive muscle weakness also affecting pulmonary function. In search of a treatment, we investigated the feasibility of enzyme replacement therapy with recombinant human α‐glucosidase from rabbit milk. Three patients (aged 11, 16, and 32 years) were enrolled in the study. They were all wheelchair‐bound and two of them were ventilator dependent with a history of deteriorating pulmonary function. After 3 years of treatment with weekly infusions of α‐glucosidase, the patients had stabilized pulmonary function and reported less fatigue. The youngest and least affected patient showed an impressive improvement of skeletal muscle strength and function. After 72 weeks of treatment, he could walk without support and finally abandoned his wheelchair. Our findings demonstrate that recombinant human α‐glucosidase from rabbit milk has a therapeutic effect in late‐onset Pompe's disease. There is good reason to continue the development of enzyme replacement therapy for Pompe's disease and to explore further the production of human therapeutic proteins in the milk of mammals. Ann Neurol 2004;55:000–000
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