Fabry disease is an X-linked multisystemic disorder caused by the impairment of lysosomal α-Galactosidase A, which leads to the progressive accumulation of glycosphingolipids and to defective lysosomal metabolism. Currently, Fabry disease is treated by enzyme replacement therapy or the orally administrated pharmacological chaperone Migalastat. Both therapeutic strategies present limitations, since enzyme replacement therapy has shown low half-life and bioavailability, while Migalastat is only approved for patients with specific mutations. The aim of this work was to assess the efficacy of PBX galactose analogues to stabilize α-Galactosidase A and therefore evaluate their potential use in Fabry patients with mutations that are not amenable to the treatment with Migalastat. We demonstrated that PBX compounds are safe and effective concerning stabilization of α-Galactosidase A in relevant cellular models of the disease, as assessed by enzymatic activity measurements, molecular modelling, and cell viability assays. This experimental evidence suggests that PBX compounds are promising candidates for the treatment of Fabry disease caused by mutations which affect the folding of α-Galactosidase A, even for GLA variants that are not amenable to the treatment with Migalastat.
法布里病是一种X连锁多系统障碍,由溶酶体α-半乳糖苷酶A的损伤引起,导致糖脂代谢的进行受到影响和逐渐积累。目前,法布里病的治疗方法包括酶替代疗法和口服药物Migalastat。这两种治疗策略都存在局限性,因为酶替代疗法的半衰期和生物利用度较低,而Migalastat只适用于特定基因突变的患者。本研究的目的是评估PBX半乳糖类似物稳定α-半乳糖苷酶A的功效,从而评估它们在无法使用Migalastat治疗的法布里病患者中的潜在用途。我们证明PBX化合物在疾病相关细胞模型中稳定α-半乳糖苷酶A是安全和有效的,通过酶活性测量、分子建模和细胞存活率检测进行评估。这些实验证据表明,PBX化合物是治疗因α-半乳糖苷酶A折叠受影响而引起的法布里病的有希望的候选药物,即使对于不适用于Migalastat治疗的GLA变异体也是如此。