Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gaucher disease is a disorder of sphingolipid metabolism resulting from an inherited deficiency of the lysosomal hydrolase glucocerebrosidase. Affected individuals present with a spectrum of clinical symptoms ranging from hepatosplenomegaly, haematological abnormalities, and bone pain in type 1 disease, to severe neurodegeneration and premature death in types 2 and 3 disease. Although the basic biochemical defect is well characterized, there remains a poor understanding of the underlying pathophysiology of disease. In vitro studies suggest that macrophage glucocerebroside storage leads to tissue dysfunction through complex mechanisms involving altered intracellular calcium homeostasis and apoptosis. In order to study the pathogenic roles of these complex interactions, a viable animal model for Gaucher disease is needed. The complexity of this single gene disorder has been emphasized by the varied results of previous murine Gaucher models, ranging from perinatal lethality to phenotypically and biochemically asymptomatic animals. Recognizing the need to modulate the biochemical phenotype in mice to produce a relevant model, we have created a murine strain with key exons of the glucocerebrosidase gene flanked by loxP sites. We show that expression of Cre-recombinase in cells of hematopoietic and endothelial origin results in deficiency of glucocerebrosidase in the liver, spleen, bone marrow, and peripheral white cells. Glucocerebroside storage in this model leads to progressive splenomegaly with Gaucher cell infiltration and modest storage in the liver by 26 weeks of age. These results indicate the utility of this loxP GBA targeted murine strain for understanding the complex pathophysiology of Gaucher disease.
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PMID:Generation of a conditional knockout of murine glucocerebrosidase: utility for the study of Gaucher disease. 1707 75

Gaucher disease (GD), the commonest lysosomal storage disorder, is an autosomal recessive condition, caused by deficiency in lysosomal glucocerebrosidase. Skeletal disease, peripheral blood cytopenias and hepato-splenomegaly are common at presentation. Several reports describe an increased risk of cancer in GD; in particular multiple myeloma. Tumor Associated Macrophages (TAMs) may promote cancerous expansion in non-GD patients, but it is unknown whether such an occurrence is present in GD. GD is traditionally described as a disorder of macrophages, associated with numerical and functional lymphoid abnormalities which could contribute to a state of impaired 'tumor surveillance'. These abnormalities include disturbances in invariant NK-T cells that depend on sphingolipid metabolism to deliver a physiological response. Glucosylceramide deposition, chronic antigenic stimulation, increased free radical production, impaired antigen presentation, reduced intra-cellular ceramide levels and disturbed autophagy have all been postulated to facilitate the growth of malignant clones in the GD microenvironment. At present, it is unknown whether carrier status for a GBA1 mutation confers an increased risk of malignancy. A cancer diagnosis is not currently an indication for GD-specific therapy in the absence of other features of the disease This article reviews cancer epidemiology, potential biological mechanisms of carcinogenesis and highlights areas of future research regarding malignancy in GD.
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PMID:Gaucher disease and myeloma. 2351 67