Advances in Diagnosis and Treatment of Fabry Disease: A Review of Clinical Manifestations and Therapeutic Interventions

Mikhail A. Popov 1, Anastasia V. Poznyak 2*, Vladislav V. Dontsov 1, Julia Y. Kotalevskaya 1, Alexey B. Zulkarnaev 1, Vadim S. Tsyplakov 1, Margarita A. Sazonova 3, Marina D. Sazonova 3, Elizaveta M. Pleshko 4, Dmitry F. Beloyartsev 5, Alexander L. Golovyuk 5, Alexey V. Churov 6, Dmitriy Yu. Serdyukov 7, Arthur A. Lee 4, 8, Victor Y Glanz 4, Vasily N. Sukhorukov 4, and Alexander N. Orekhov 4*

This review discussed a treatment algorithm for advancing medicine, and patient outcomes of Fabry disease.

Abstract

At present, early diagnosis of many orphan diseases is difficult due to their rare occurrence and insufficient knowledge of them. This article presents a review of the literature and our study of Fabry disease (FD), a rare genetic multisystem disease which belongs to the group of lysosomal storage diseases. This disease is based on a deficiency of the lysosomal enzyme α-galactosidase A (α-Gal A), which leads to the progressive accumulation of glycolipid Gb3 in lysosomes in almost all cells of the body, causing extensive organ damage and an increase in plasma levels of globotriaosylsphingosine (lyso-Gb3 product of degradation of accumulated Gb3. Objective: The aim is to provide a comprehensive overview of modern knowledge and current research in the field of pathophysiology, diagnosis and treatment of heart damage in FD, to evaluate the characteristics of diagnosed patients living on the territory of the Moscow region, and to develop and propose for spreading an algorithm for the early detection of this pathology. Methods: A retrospective analysis of the medical records of 12 patients with an estab-lished diagnosis of Fabry disease was carried out. Data from 12 patients with FD, undergoing enzyme replacement therapy of varying durations were analyzed. All patients had left ventricular hypertrophy (LVH) and hypertrophic cardiomyopathy, with 9 having LVH diagnosed during a diagnosis. 7 patients get a cardioprotective therapy. All patients underwent molecular genetic testing. In 3 cases there was fa-tal case. Results: The data were analyzed and molecular genetic markers of FD were detected for the purpose of selective screening for FD in the study sample. Conclusion: An algorithm for the early diagnosis of FD has been developed and presented for distribution among general practitioners and cardiologists.

Keywords: Orphan diseases, Fabry disease, Agalsidase alfa, Fabry disease detection algorithm

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