Oxidative stress biomarkers in Fabry disease: is there a room for them?

J Neurol. 2020 Dec;267(12):3741-3752. doi: 10.1007/s00415-020-10044-w. Epub 2020 Jul 27.

Abstract

Background: Fabry disease (FD) is an X-linked lysosomal storage disorder, caused by deficient activity of the alpha-galactosidase A enzyme leading to progressive and multisystemic accumulation of globotriaosylceramide. Recent data point toward oxidative stress signalling which could play an important role in both pathophysiology and disease progression.

Methods: We have examined oxidative stress biomarkers [Advanced Oxidation Protein Products (AOPP), Ferric Reducing Antioxidant Power (FRAP), thiolic groups] in blood samples from 60 patients and 77 healthy controls.

Results: AOPP levels were higher in patients than in controls (p < 0.00001) and patients presented decreased levels of antioxidant defences (FRAP and thiols) with respect to controls (p < 0.00001). In a small group of eight treatment-naïve subjects with FD-related mutations, we found altered levels of oxidative stress parameters and incipient signs of organ damage despite normal lyso-Gb3 levels.

Conclusions: Oxidative stress occurs in FD in both treated and naïve patients, highlighting the need of further research in oxidative stress-targeted therapies. Furthermore, we found that oxidative stress biomarkers may represent early markers of disease in treatment-naïve patients with a potential role in helping interpretation of FD-related mutations and time to treatment decision.

Keywords: Biomarkers; Fabry disease; Oxidative stress; lysoGb3.

MeSH terms

  • Biomarkers
  • Fabry Disease* / diagnosis
  • Fabry Disease* / genetics
  • Humans
  • Mutation / genetics
  • Oxidative Stress
  • alpha-Galactosidase / genetics

Substances

  • Biomarkers
  • alpha-Galactosidase