Lysosomal storage diseases Flashcards

1
Q

What are lysosomal storage diseases?

A

LSDs are a group of monogenic metabolic diseases involving or controlled by a single gene.

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2
Q

What mutations are involved?

A

Mutations in genes coding for particular enzymes (acid hydrolyses) and lysosomal membrane proteins.

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3
Q

How are LSDs classified?

A

LSD can be classified either by the substrate that accumulates or the gene that is mutated.

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4
Q

Describe the structure of the lysosome.

A

The lysosome is a spherical membrane-enclosed organelle.

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5
Q

What is the optimal pH of the lysosome and why?

A

The pH of the lysosome is 4.5-5, which is the optimal pH for hydrolases and is maintained by the proton pump ATPase/H+.

If the lysosome breaks down in the cell, the enzymes released do not act on intracellular components of the cells, since they are neutralised by the pH of the cytosol and rendered inactive.

This is why the pH is considered protective.

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6
Q

What are the main functions of the lysosome?

A
Endocytosis
Autophagy 
Apoptosis
UPR 
Interactions with mitochondria
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7
Q

How are lysosomes involved in endocytosis?

A

Internalisation of extracellular material.

Invagination of the plasma membrane and the formation of vesicles.

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8
Q

How are lysosomes involved in autophagy?

A

Destruction and recycling of damaged cellular material the body.

Involves the formation of autophagosomes.

Triggered by cell starvation.

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9
Q

How are lysosomes involved in apoptosis?

A

Programmed cell death.

Membrane of the lysosome becomes increasingly permeable.

Releases proteases in the cytosol including cysteine and cathepsin.

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10
Q

How are lysosomes involved in the unfolded protein response?

A

UPR - involves the removal of misfiled proteins and up-regulation of proteasomes and molecular chaperones involved in protein folding.

If these objectives are not achieved - apoptosis.

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11
Q

What interactions do lysosomes have with mitochondria and calcium signalling?

A

Cross talk between the lysosomes and mitochondria allows:

Degradation of dysfunctional mitochondria.

Maintenance of lysosomal function by acidification

Regulation of mitochondrial catabolism

Facilitation of calcium signalling which is involved in autophagy, membrane fusion and apoptosis.

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12
Q

How do lysosomes respond to specific protein mutations?

A

Enzyme mutations can lead to the accumulation of biomolecules.

Protein channel mutations can lead to the inappropriate transport of substances in the cellular environment.

Lysosomes are the main source of source damage from these mutations because aggregation usually occurs within the lysosome.

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13
Q

Give some characteristics of lysosomal dysfunction

A

Dysfunctional biosynthesis and catabolism of glycosphingolipids

Accumulation of substrates

Failed trafficking

Expansion of the lysosomal network and increased activity

Disturbed autophagy -membrane fusion and expansion

Disturbed calcium signalling and neurotoxicity

Apoptosis

Necroptosis – caspase independent cell death

Disruption of lipid raft

Macrophage activation

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14
Q

Complete disruption of the GSL (glycosphingolipid) pathway is incompatible with life.

True or false?

A

True

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15
Q

What is Krabbe disease?

A

Upregulation of metabolites from GAGs

Leads to the activation of receptors, secretion of cytokines, apoptotic signalling

GAGs are made elsewhere in the cells and their similarity to bacterial endotoxins activates immune response.

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16
Q

What is GalCer disease?

A

Mutations in enzymes can lead to the inhibition of cytokines

17
Q

What are CLN diseases?

A

Involve the upregulation of ceramide synthesis which leads to apoptosis of the cell

18
Q

What is GlcCer disease?

A

Mutation in a specific enzyme
Leads to an increase in calcium ion concentration
Which causes neurotoxicity

19
Q

What is Sandhoff disease?

A

Inhibition of calcium re-uptake into the ER causes:

Disruption to UPR
Caspase release
Apoptosis

20
Q

Why are LSDs difficult to treat?

A

Presentation varies greatly.

Genes can have the same or different mutations that can affect different organs.

A similar build-up of substrate can be caused by different disruptions to the pathway.

21
Q

How can we split the clinical features of LSDs?

A

By visceral presentation

Neurological presentation

22
Q

Give some examples of visceral LSD

A

Organomegaly – hepatosplenomegaly

Cardiomyopathy - cardiomegaly, heart failure, glycogen deposition

Respiratory manifestations - hypotonicity and lung volume reduction

Haematological and endocrine symptoms - anaemia, thrombocytopenia, enlarged endocrine glands

Fetal oedema

Bone abnormalities abnormal formation, joint contractures and swelling

Cutaneous manifestations lesions, ichthyosis

Dysmorphic features - depressed nasal septum