BACKGROUND: Pegunigalsidase alfa is a PEGylated α-galactosidase A enzyme replacement therapy. BALANCE (NCT02795676) assessed non-inferiority of pegunigalsidase alfa versus agalsidase beta in adults with Fabry disease with an annualised estimated glomerular filtration rate (eGFR) slope more negative than -2 mL/min/1.73 m2/year who had received agalsidase beta for ≥1 year. METHODS: Patients were randomly assigned 2:1 to receive 1 mg/kg pegunigalsidase alfa or agalsidase beta every 2 weeks for 2 years. The primary efficacy analysis assessed non-inferiority based on median annualised eGFR slope differences between treatment arms. RESULTS: Seventy-seven patients received either pegunigalsidase alfa (n=52) or agalsidase beta (n=25). At baseline, mean (range) age was 44 (18-60) years, 47 (61%) patients were male, median eGFR was 74.5 mL/min/1.73 m2 and median (range) eGFR slope was -7.3 (-30.5, 6.3) mL/min/1.73 m2/year. At 2 years, the difference between median eGFR slopes was -0.36 mL/min/1.73 m2/year, meeting the prespecified non-inferiority margin. Minimal changes were observed in lyso-Gb3 concentrations in both treatment arms at 2 years. Proportions of patients experiencing treatment-related adverse events and mild or moderate infusion-related reactions were similar in both groups, yet exposure-adjusted rates were 3.6-fold and 7.8-fold higher, respectively, with agalsidase beta than pegunigalsidase alfa. At the end of the study, neutralising antibodies were detected in 7 out of 47 (15%) pegunigalsidase alfa-treated patients and 6 out of 23 (26%) agalsidase beta-treated patients. There were no deaths. CONCLUSIONS: Based on rate of eGFR decline over 2 years, pegunigalsidase alfa was non-inferior to agalsidase beta. Pegunigalsidase alfa had lower rates of treatment-emergent adverse events and mild or moderate infusion-related reactions. TRIAL REGISTRATION NUMBER: NCT02795676.

• Klíčová slova
• Drug-Related Side Effects and Adverse Reactions, Fabry Disease, Genetic Diseases, Inborn, Genetic Diseases, X-Linked, alpha-Galactosidase,
• MeSH
• alfa-galaktosidasa * terapeutické užití   aplikace a dávkování   škodlivé účinky   genetika   MeSH
• dospělí MeSH
• enzymová substituční terapie * metody   MeSH
• Fabryho nemoc * farmakoterapie   MeSH
• hodnoty glomerulární filtrace * účinky léků   MeSH
• izoenzymy * terapeutické užití   škodlivé účinky   aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• rekombinantní proteiny * aplikace a dávkování   terapeutické užití   škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• agalsidase alfa MeSH Prohlížeč
• agalsidase beta MeSH Prohlížeč

Fabry disease (FD, α-galactosidase A deficiency) is a rare, progressive, complex lysosomal storage disorder affecting multiple organ systems with a diverse spectrum of clinical phenotypes, particularly among female patients. Knowledge of its clinical course was still limited in 2001 when FD-specific therapies first became available and the Fabry Registry (NCT00196742; sponsor: Sanofi) was initiated as a global observational study. The Fabry Registry has now been operational for over 20 years, overseen by expert Boards of Advisors, and has collected real-world demographic and longitudinal clinical data from more than 8000 individuals with FD. Leveraging the accumulating evidence base, multidisciplinary collaborations have resulted in the creation of 32 peer-reviewed scientific publications, which have contributed to the greatly expanded knowledge on the onset and progression of FD, its clinical management, the role of sex and genetics, the outcomes of enzyme replacement therapy with agalsidase beta, and prognostic factors. We review how the Fabry Registry has evolved from its inception to become the largest global source of real-world FD patient data, and how the generated scientific evidence has helped to better inform the medical community, individuals living with FD, patient organizations, and other stakeholders. The patient-centered Fabry Registry fosters collaborative research partnerships with the overarching goal of optimizing the clinical management of patients with FD and is well positioned to add to its past achievements.

• Klíčová slova
• Fabry disease, Registry, agalsidase beta, enzyme replacement therapy, natural history, real-world data,
• MeSH
• alfa-galaktosidasa genetika   terapeutické užití   MeSH
• enzymová substituční terapie metody   MeSH
• Fabryho nemoc * farmakoterapie   epidemiologie   genetika   MeSH
• fenotyp MeSH
• lidé MeSH
• péče orientovaná na pacienta MeSH
• pozorovací studie jako téma MeSH
• registrace MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• alfa-galaktosidasa MeSH

Fabry disease is an X-linked lysosomal storage disorder caused by mutations in the GLA gene leading to deficient α-galactosidase A activity, glycosphingolipid accumulation, and life-threatening complications. Phenotypes vary from the "classic" phenotype, with pediatric onset and multi-organ involvement, to later-onset, a predominantly cardiac phenotype. Manifestations are diverse in female patients in part due to variations in residual enzyme activity and X chromosome inactivation patterns. Enzyme replacement therapy (ERT) and adjunctive treatments can provide significant clinical benefit. However, much of the current literature reports outcomes after late initiation of ERT, once substantial organ damage has already occurred. Updated monitoring and treatment guidelines for pediatric patients with Fabry disease have recently been published. Expert physician panels were convened to develop updated, specific guidelines for adult patients. Management of adult patients depends on 1) a personalized approach to care, reflecting the natural history of the specific disease phenotype; 2) comprehensive evaluation of disease involvement prior to ERT initiation; 3) early ERT initiation; 4) thorough routine monitoring for evidence of organ involvement in non-classic asymptomatic patients and response to therapy in treated patients; 5) use of adjuvant treatments for specific disease manifestations; and 6) management by an experienced multidisciplinary team.

• Klíčová slova
• Diagnosis, Fabry disease, Management, Mutation, Treatment,
• MeSH
• alfa-galaktosidasa aplikace a dávkování   MeSH
• dospělí MeSH
• enzymová substituční terapie * MeSH
• Fabryho nemoc enzymologie   terapie   MeSH
• lidé MeSH
• management nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• alfa-galaktosidasa MeSH

Cancer is a major public health problem worldwide. In the United States alone, 1 in 4 deaths is due to cancer and for 2013 a total of 1,660,290 new cancer cases and 580,350 cancer-related deaths are projected. Comprehensive profiling of multiple cancer genomes has revealed a highly complex genetic landscape in which a large number of altered genes, varying from tumor to tumor, impact core biological pathways and processes. This has implications for therapeutic targeting of signaling networks in the development of treatments for specific cancers. The NFκB transcription factor is constitutively active in a number of hematologic and solid tumors, and many signaling pathways implicated in cancer are likely connected to NFκB activation. A critical mediator of NFκB activity is TGFβ-activated kinase 1 (TAK1). Here, we identify TAK1 as a novel interacting protein and target of fibroblast growth factor receptor 3 (FGFR3) tyrosine kinase activity. We further demonstrate that activating mutations in FGFR3 associated with both multiple myeloma and bladder cancer can modulate expression of genes that regulate NFκB signaling, and promote both NFκB transcriptional activity and cell adhesion in a manner dependent on TAK1 expression in both cancer cell types. Our findings suggest TAK1 as a potential therapeutic target for FGFR3-associated cancers, and other malignancies in which TAK1 contributes to constitutive NFκB activation.

• MeSH
• apoptóza MeSH
• buněčná adheze MeSH
• fosforylace MeSH
• imunoprecipitace MeSH
• kvantitativní polymerázová řetězová reakce MeSH
• lidé MeSH
• MAP kinasy kinas (kinas) genetika   metabolismus   MeSH
• messenger RNA genetika   MeSH
• mnohočetný myelom genetika   metabolismus   patologie   MeSH
• nádorové biomarkery genetika   metabolismus   MeSH
• nádorové buňky kultivované MeSH
• nádory močového měchýře genetika   metabolismus   patologie   MeSH
• NF-kappa B genetika   metabolismus   MeSH
• peptidové fragmenty MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• proliferace buněk MeSH
• receptor fibroblastových růstových faktorů, typ 3 genetika   metabolismus   MeSH
• sekvenční analýza hybridizací s uspořádaným souborem oligonukleotidů MeSH
• signální transdukce MeSH
• spektrometrie hmotnostní - ionizace laserem za účasti matrice MeSH
• stanovení celkové genové exprese MeSH
• techniky dvojhybridového systému MeSH
• transformující růstový faktor beta genetika   metabolismus   MeSH
• tyrosin metabolismus   MeSH
• western blotting MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• FGFR3 protein, human MeSH Prohlížeč
• MAP kinase kinase kinase 7 MeSH Prohlížeč
• MAP kinasy kinas (kinas) MeSH
• messenger RNA MeSH
• nádorové biomarkery MeSH
• NF-kappa B MeSH
• peptidové fragmenty MeSH
• receptor fibroblastových růstových faktorů, typ 3 MeSH
• transformující růstový faktor beta MeSH
• tyrosin MeSH

In 1994, the field of bone biology was significantly advanced by the discovery that activating mutations in the fibroblast growth factor receptor 3 (FGFR3) receptor tyrosine kinase (TK) account for the common genetic form of dwarfism in humans, achondroplasia (ACH). Other conditions soon followed, with the list of human disorders caused by FGFR3 mutations now reaching at least 10. An array of vastly different diagnoses is caused by similar mutations in FGFR3, including syndromes affecting skeletal development (hypochondroplasia [HCH], ACH, thanatophoric dysplasia [TD]), skin (epidermal nevi, seborrhaeic keratosis, acanthosis nigricans), and cancer (multiple myeloma [MM], prostate and bladder carcinoma, seminoma). Despite many years of research, several aspects of FGFR3 function in disease remain obscure or controversial. As FGFR3-related skeletal dysplasias are caused by growth attenuation of the cartilage, chondrocytes appear to be unique in their response to FGFR3 activation. However, the reasons why FGFR3 inhibits chondrocyte growth while causing excessive cellular proliferation in cancer are not clear. Likewise, the full spectrum of molecular events by which FGFR3 mediates its signaling is just beginning to emerge. This article describes the challenging journey to unravel the mechanisms of FGFR3 function in skeletal dysplasias, the extraordinary cellular manifestations of FGFR3 signaling in chondrocytes, and finally, the progress toward therapy for ACH and cancer.

• MeSH
• chondrocyty metabolismus   patologie   MeSH
• chrupavka abnormality   metabolismus   MeSH
• fibroblastové růstové faktory genetika   metabolismus   MeSH
• fosfatidylinositol-3-kinasy genetika   metabolismus   MeSH
• kosti a kostní tkáň abnormality   metabolismus   MeSH
• kůže metabolismus   patologie   MeSH
• letální geny MeSH
• lidé MeSH
• MAP kinasový signální systém genetika   MeSH
• mezibuněčná komunikace MeSH
• mutace MeSH
• nádory kůže genetika   metabolismus   patologie   MeSH
• natriuretický peptid typu C genetika   metabolismus   MeSH
• osteochondrodysplazie genetika   metabolismus   patologie   MeSH
• proliferace buněk MeSH
• receptor fibroblastových růstových faktorů, typ 3 * genetika   metabolismus   MeSH
• regulace genové exprese MeSH
• signální transdukce MeSH
• transkripční faktor STAT1 genetika   metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• FGFR3 protein, human MeSH Prohlížeč
• fibroblastové růstové faktory MeSH
• fosfatidylinositol-3-kinasy MeSH
• natriuretický peptid typu C MeSH
• receptor fibroblastových růstových faktorů, typ 3 * MeSH
• STAT1 protein, human MeSH Prohlížeč
• transkripční faktor STAT1 MeSH

LDL-related protein 6 (LRP6) is a coreceptor of WNTs and a key regulator of the WNT/β-catenin pathway. Upon activation, LRP6 is phosphorylated within its intracellular PPPS/TP motifs. These phosphorylated motifs are required to recruit axin and to inhibit glycogen synthase kinase 3 (GSK3), two basic components of the β-catenin destruction complex. On the basis of a kinome-wide small interfering RNA (siRNA) screen and confirmative biochemical analysis, we show that several proline-directed mitogen-activated protein kinases (MAPKs), such as p38, ERK1/2, and JNK1 are sufficient and required for the phosphorylation of PPPS/TP motifs of LRP6. External stimuli, which control the activity of MAPKs, such as phorbol esters and fibroblast growth factor 2 (FGF2) control the choice of the LRP6-PPPS/TP kinase and regulate the amplitude of LRP6 phosphorylation and WNT/β-catenin-dependent transcription. Our findings suggest that cells not only recruit one dedicated LRP6 kinase but rather select their LRP6 kinase depending on cell type and the external stimulus. Moreover, direct phosphorylation of LRP6 by MAPKs provides a unique point for convergence between WNT/β-catenin signaling and mitogenic pathways.

• MeSH
• aminokyselinové motivy MeSH
• beta-katenin metabolismus   MeSH
• buněčné linie MeSH
• fosforylace MeSH
• krysa rodu Rattus MeSH
• LDL receptor related protein 6 MeSH
• lidé MeSH
• malá interferující RNA genetika   MeSH
• MAP kinasový signální systém MeSH
• mitogenem aktivovaná proteinkinasa 8 metabolismus   MeSH
• mitogenem aktivované proteinkinasy p38 metabolismus   MeSH
• mitogenem aktivované proteinkinasy antagonisté a inhibitory   genetika   metabolismus   MeSH
• nádorové buňky kultivované MeSH
• proteiny související s LDL-receptory chemie   genetika   metabolismus   MeSH
• proteiny Wnt metabolismus   MeSH
• receptory LDL metabolismus   MeSH
• signální transdukce MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, N.I.H., Intramural MeSH
• Názvy látek
• beta-katenin MeSH
• CTNNB1 protein, human MeSH Prohlížeč
• LDL receptor related protein 6 MeSH
• LRP6 protein, human MeSH Prohlížeč
• malá interferující RNA MeSH
• mitogenem aktivovaná proteinkinasa 8 MeSH
• mitogenem aktivované proteinkinasy p38 MeSH
• mitogenem aktivované proteinkinasy MeSH
• proteiny související s LDL-receptory MeSH
• proteiny Wnt MeSH
• receptory LDL MeSH

Oncogenic activation of the RAS-ERK MAP kinase signaling pathway can lead to uncontrolled proliferation but can also result in apoptosis or premature cellular senescence, both regarded as natural protective barriers to cell immortalization and transformation. In FGFR3-related skeletal dyplasias, oncogenic mutations in the FGFR3 receptor tyrosine kinase cause profound inhibition of cartilage growth resulting in severe dwarfism, although many of the precise mechanisms of FGFR3 action remain unclear. Mutated FGFR3 induces constitutive activation of the ERK pathway in chondrocytes and, remarkably, can also cause both increased proliferation and apoptosis in growing cartilage, depending on the gestational age. Here, we demonstrate that FGFR3 signaling is also capable of inducing premature senescence in chondrocytes, manifested as reversible, ERK-dependent growth arrest accompanied by alteration of cellular shape, loss of the extracellular matrix, upregulation of senescence markers (alpha-GLUCOSIDASE, FIBRONECTIN, CAVEOLIN 1, LAMIN A, SM22alpha and TIMP 1), and induction of senescence-associated beta-GALACTOSIDASE activity. Our data support a model whereby FGFR3 signaling inhibits cartilage growth via exploiting cellular responses originally designed to eliminate cells harboring activated oncogenes.

• MeSH
• apoptóza MeSH
• chondrocyty enzymologie   patologie   MeSH
• extracelulární matrix metabolismus   MeSH
• extracelulárním signálem regulované MAP kinasy metabolismus   MeSH
• fenotyp MeSH
• krysa rodu Rattus MeSH
• onkogeny genetika   MeSH
• proliferace buněk MeSH
• receptor fibroblastových růstových faktorů, typ 3 metabolismus   MeSH
• signální transdukce * MeSH
• stárnutí buněk * MeSH
• tvar buňky MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• extracelulárním signálem regulované MAP kinasy MeSH
• receptor fibroblastových růstových faktorů, typ 3 MeSH

The human fibroblast growth factor (FGF) family contains 22 proteins that regulate a plethora of physiological processes in both developing and adult organism. The mutations in the FGF genes were not known to play role in human disease until the year 2000, when mutations in FGF23 were found to cause hypophosphatemic rickets. Nine years later, seven FGFs have been associated with human disorders. These include FGF3 in Michel aplasia; FGF8 in cleft lip/palate and in hypogonadotropic hypogonadism; FGF9 in carcinoma; FGF10 in the lacrimal/salivary glands aplasia, and lacrimo-auriculo-dento-digital syndrome; FGF14 in spinocerebellar ataxia; FGF20 in Parkinson disease; and FGF23 in tumoral calcinosis and hypophosphatemic rickets. The heterogeneity in the functional consequences of FGF mutations, the modes of inheritance, pattern of involved tissues/organs, and effects in different developmental stages provide fascinating insights into the physiology of the FGF signaling system. We review the current knowledge about the molecular pathology of the FGF family.

• MeSH
• fibroblastové růstové faktory genetika   metabolismus   MeSH
• fibroblastový růstový faktor 23 MeSH
• hypogonadismus genetika   metabolismus   MeSH
• karcinom genetika   metabolismus   MeSH
• lidé MeSH
• mnohočetné abnormality genetika   MeSH
• mutace * MeSH
• rozštěp rtu genetika   metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• FGF23 protein, human MeSH Prohlížeč
• fibroblastové růstové faktory MeSH
• fibroblastový růstový faktor 23 MeSH

Activation of fibroblast growth factor receptor 3 (FGFR3) leads to attenuation of cartilage growth. The members of the STAT family of transcription factors are believed to participate in FGFR3 signaling in cartilage, however the molecular mechanism of this action is poorly understood. Here, we demonstrate that a chronic FGF stimulus leads to accumulation of STAT1, 3, 5 and 6, evident in both in vitro chondrocyte model and murine limb explant cultures. Despite the accumulation, both endogenous and cytokine-induced activation of STAT1 and STAT3 is impaired by FGF, as demonstrated by imaging of active STAT nuclear translocation and analyses of STAT activatory phosphorylation and transcriptional activation. Further, we demonstrate that FGF induces expression of CIS, SOCS1 and SOCS3 inhibitors of gp130, a common receptor for the IL6-family of cytokines. Since cytokine-gp130 signaling represents an important positive regulator of cartilage, its inhibition may contribute to the growth-inhibitory effect of FGFR3 in cartilage.

• MeSH
• chondrocyty účinky léků   metabolismus   MeSH
• cytokinový receptor gp130 metabolismus   MeSH
• fibroblastový růstový faktor 2 farmakologie   MeSH
• interferon gama antagonisté a inhibitory   farmakologie   MeSH
• interleukin-6 antagonisté a inhibitory   farmakologie   MeSH
• myši MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• protein SOCS1 MeSH
• protein SOCS3 MeSH
• proteiny SOCS metabolismus   MeSH
• receptor fibroblastových růstových faktorů, typ 3 metabolismus   MeSH
• sekvence nukleotidů MeSH
• signální transdukce MeSH
• transkripční faktor STAT1 antagonisté a inhibitory   metabolismus   MeSH
• transkripční faktor STAT3 antagonisté a inhibitory   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• cytokine inducible SH2-containing protein MeSH Prohlížeč
• cytokinový receptor gp130 MeSH
• fibroblastový růstový faktor 2 MeSH
• interferon gama MeSH
• interleukin-6 MeSH
• protein SOCS1 MeSH
• protein SOCS3 MeSH
• proteiny SOCS MeSH
• receptor fibroblastových růstových faktorů, typ 3 MeSH
• Socs1 protein, mouse MeSH Prohlížeč
• Socs3 protein, mouse MeSH Prohlížeč
• transkripční faktor STAT1 MeSH
• transkripční faktor STAT3 MeSH

Activating mutations in FGFR3 tyrosine kinase cause several forms of human skeletal dysplasia. Although the mechanisms of FGFR3 action in cartilage are not completely understood, it is believed that the STAT1 transcription factor plays a central role in pathogenic FGFR3 signaling. Here, we analyzed STAT1 activation by the N540K, G380R, R248C, Y373C, K650M and K650E-FGFR3 mutants associated with skeletal dysplasias. In a cell-free kinase assay, only K650M and K650E-FGFR3 caused activatory STAT1(Y701) phosphorylation. Similarly, in RCS chondrocytes, HeLa, and 293T cellular environments, only K650M and K650E-FGFR3 caused strong STAT1 activation. Other FGFR3 mutants caused weak (HeLa) or no activation (293T and RCS). This contrasted with ERK MAP kinase activation, which was strongly induced by all six mutants and correlated with the inhibition of proliferation in RCS chondrocytes. Thus the ability to activate STAT1 appears restricted to the K650M and K650E-FGFR3 mutants, which however account for only a small minority of the FGFR3-related skeletal dysplasia cases. Other pathways such as ERK should therefore be considered as central to pathological FGFR3 signaling in cartilage.

• MeSH
• bezbuněčný systém metabolismus   MeSH
• biologické modely MeSH
• CHO buňky MeSH
• chrupavka metabolismus   MeSH
• Cricetulus MeSH
• extracelulárním signálem regulované MAP kinasy metabolismus   MeSH
• fosforylace MeSH
• HeLa buňky MeSH
• kosti a kostní tkáň patologie   MeSH
• křečci praví MeSH
• krysa rodu Rattus MeSH
• kultivované buňky MeSH
• lidé MeSH
• mutantní proteiny fyziologie   MeSH
• receptor fibroblastových růstových faktorů, typ 3 genetika   fyziologie   MeSH
• signální transdukce genetika   fyziologie   MeSH
• transkripční faktor STAT1 analýza   metabolismus   fyziologie   MeSH
• vývojové onemocnění kostí genetika   metabolismus   patologie   MeSH
• zvířata MeSH
• Check Tag
• křečci praví MeSH
• krysa rodu Rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• extracelulárním signálem regulované MAP kinasy MeSH
• mutantní proteiny MeSH
• receptor fibroblastových růstových faktorů, typ 3 MeSH
• transkripční faktor STAT1 MeSH