heparitin-sulfate and Brain-Diseases

All patients with neurologic diseases should receive perioperative VTE prophylaxis. The choice of mechanical, pharmacologic, or combined modalities of prophylaxis depends on both the underlying risk factors and surgical VTE risks. Prophylaxis and treatment options must be individualized to the patient. Prevention of VTE will help minimize the need for therapeutic treatment. Options for treatment include both inpatient and outpatient regimens using UFH or LMWH. In patients with an absolute or relative contraindication to anticoagulation, an IVC filter is an appropriate management strategy. Perioperative bridging therapy should be considered in patients with high or moderate risks for recurrent VTE.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Aspirin; Brain Diseases; Chondroitin Sulfates; Dermatan Sulfate; Dose-Response Relationship, Drug; Drug Combinations; Fibrinolytic Agents; Heparin; Heparitin Sulfate; Humans; Postoperative Complications; Venous Thrombosis; Warfarin

We have described the age-related deposition of fibrillar material in brains of B6 mice and SAM. Since in other inbred strains similar deposits were absent or occurred only occasionally and only in aged individuals, a genetic predisposition of B6 mice and SAM to accumulate the fibrillar material is suggested. The deposits are mostly associated with astrocytic processes and have been referred to as astrocytic inclusions. HSPG- and laminin-like molecules have been identified as components of the fibrillar material. The deposits have similarities with CA in humans, but they also show some important differences; thus there is presently insufficient evidence to consider the deposits the murine equivalent of CA. Although the physiological significance of the fibrillar material is not yet clear, the awareness of the deposits appears pertinent because they might contribute to various aspects of CNS function of susceptible strains of mice, and therefore could lead to possible misinterpretations of the results of studies employing these strains. Future directions of our research will determine the potential of the murine deposits to model aspects of human neuropathology, in particular, whether the deposits may mimic the deposition of ECM molecules as an early-event in the pathogenesis of amyloid plaque formation.

Topics: Aging; Animals; Biomarkers; Brain Diseases; Central Nervous System Diseases; Disease Models, Animal; Female; Heparan Sulfate Proteoglycans; Heparitin Sulfate; Humans; Laminin; Male; Mice; Mice, Inbred Strains; Neurofibrils; Proteoglycans; Species Specificity

Mucopolysaccharidosis type IIIA (MPS IIIA) is a lysosomal storage disorder caused by N-sulfoglucosamine sulfohydrolase (SGSH) deficiency. SGSH removes the sulfate from N-sulfoglucosamine residues on the nonreducing end of heparan sulfate (HS-NRE) within lysosomes. Enzyme deficiency results in accumulation of partially degraded HS within lysosomes throughout the body, leading to a progressive severe neurological disease. Enzyme replacement therapy has been proposed, but further evaluation of the treatment strategy is needed. Here, we used Chinese hamster ovary cells to produce a highly soluble and fully active recombinant human sulfamidase (rhSGSH). We discovered that rhSGSH utilizes both the CI-MPR and LRP1 receptors for uptake into patient fibroblasts. A single intracerebroventricular (ICV) injection of rhSGSH in MPS IIIA mice resulted in a tissue half-life of 9 days and widespread distribution throughout the brain. Following a single ICV dose, both total HS and the MPS IIIA disease-specific HS-NRE were dramatically reduced, reaching a nadir 2 weeks post dose. The durability of effect for reduction of both substrate and protein markers of lysosomal dysfunction and a neuroimmune response lasted through the 56 days tested. Furthermore, seven weekly 148 μg doses ICV reduced those markers to near normal and produced a 99.5% reduction in HS-NRE levels. A pilot study utilizing every other week dosing in two animals supports further evaluation of less frequent dosing. Finally, our dose-response study also suggests lower doses may be efficacious. Our findings show that rhSGSH can normalize lysosomal HS storage and markers of a neuroimmune response when delivered ICV.

Topics: Animals; Brain; Brain Diseases; CHO Cells; Cricetinae; Cricetulus; Disease Models, Animal; Heparitin Sulfate; Humans; Hydrolases; Lysosomes; Mice; Mucopolysaccharidosis III; Pilot Projects