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== Summary == Fabry disease is a rare genetic disease, that is inherited via the X chromosome and causes a defect in the gene GAL. It is a [http://en.wikipedia.org/wiki/Lysosomal_storage_disease Lysosomal storage disease] and therefore causes a wide range of [https://i12r-studfilesrv.informatik.tu-muenchen.de/wiki/index.php/Fabry_Disease#Symptoms symptoms]. The disease is named after the German Johannes Fabry, who described the disease in 1898 simultaneous with William Anderson from UK. == Phenotype == === Symptoms === As the effects caused by the enzymatic dysfunction accumulate over time, the symptoms evolve progressively. The symptoms occuring during childhood, are generally not specific for Fabry disease, thus it is rarely diagnosed at that stage. The most significant symptom for Fabry disease are dark red skin rashes, that usually evolve during adolescence. The most restrictive and dangerous symptoms emerge at an age of ~30-35.<ref name=fabrycom>http://www.fabrycommunity.com/en/Patients/Education/Progression.aspx</ref> ==== Childhood ==== * Pain and burning in the hands and feet * Impaired sweating * Psychological and social issues * Low tolerance for exercise * Eye abnormalities ==== Adolescence ==== * Dark red skin rashes ([http://en.wikipedia.org/wiki/Angiokeratoma angiokeratomas]) * Fatigue * Gastrointestinal problems ==== Adulthood ==== * Heart problems * Kidney problems * Nervous system problems * Hearing problems === Cross-references === See also description of this disease in * [http://en.wikipedia.org/wiki/Fabry_disease Wikipedia] * [http://www.hgmd.cf.ac.uk/ac/gene.php?gene=GLA HGMD] * [http://www.ncbi.nlm.nih.gov/omim/301500 OMIM:Fabry Disease] * [http://www.ncbi.nlm.nih.gov/pubmed?term=Fabry%20Disease PubMed] * [http://www.ninds.nih.gov/disorders/fabrys/fabrys.htm NINDS] * [http://ghr.nlm.nih.gov/condition/fabry-disease GHR] * [http://www.ncbi.nlm.nih.gov/books/NBK1292/ NCBI Bookshelf] * [http://emedicine.medscape.com/article/951451-overview Medscape] == &alpha;-galactosidase A == === Gene === [[Image:Fabry_disease_gla_chromosome_locus.jpeg|thumb|right|The location of the gene GLA on the X chromosome.<ref name=location_chromosome>[http://ghr.nlm.nih.gov/gene/GLA ghr.nlm.nih.gov]</ref>]] The protein &alpha;-galactosidase A is encoded by the gene GLA, which is locacted on the X chromosome (gene map locus: Xq22). The gene has an overall length of 10,222 nucleotides and consists of 7 exons (1,290 nucleotides) and 6 introns (8,932 nucleotides). ==== Cross-references ==== * [http://www.ncbi.nlm.nih.gov/gene/2717 NCBI: GLA] * [http://www.ncbi.nlm.nih.gov/omim/300644 OMIM: GLA] * [http://www.genome.jp/dbget-bin/www_bget?hsa:2717 KEGG: GLA] * [http://ghr.nlm.nih.gov/gene/GLA Genetics Home Reference: GLA] === Protein === [[Image:Fabry_disease_pdb_1r47.jpg|thumb|right|Representation of the protein &alpha;-galactosidase A.<ref name=pdb_structure>[http://www.pdb.org/pdb/explore/explore.do?structureId=1R47 PDB ID: IR47]</ref>]] &alpha;-galactosidase A is a homodimeric protein that consist of 398 amino acids. It is a glycosidase (EC number: 3.2.1.22) and hydrolyses O- and S-glycosidic bonds of glycolipids. ==== Cross-references ==== * [http://www.genome.jp/dbget-bin/www_bget?ec:3.2.1.22 KEGG: EC 3.2.1.22] * [http://biocyc.org/META/NEW-IMAGE?type=ENZYME&object=CPLX-8228 MetaCyc: &alpha;-Galactosidase A] * [http://www.rcsb.org/pdb/explore/explore.do?pdbId=1r47 PDB: 1R47] * [http://www.uniprot.org/uniprot/P06280 UniProt: &alpha;-galactosidase A] * [http://de.wikipedia.org/wiki/%CE%91-Galactosidase Wikipedia: &alpha;-galactosidase A] == Biochemical disease mechanism == [[Image:Fabry_disease_glycosphingolipid_pathway.png|thumb|right|Glycosphingolipid biosynthesis of Homo sapiens. The disease associated enzyme is highlighted in red.<ref name=kegg_pathway>[http://www.genome.jp/kegg-bin/show_pathway?hsa00603+2717 KEGG Pathway: glycosphingolipid biosynthesis]</ref>]] [[Image:Fabry_disease_alpha_galactosidase_gl3_to_gl2.jpg|thumb|right|The hydrolysation of globotriaosylceramide (GL3) to lactosylceramide (GL2) and galactose is catalyzed by the protein &alpha;-galactosidase A.<ref name=gl3_to_gl2>[http://www.genzyme.co.il/index.aspx?id=2730 genzyme.co.il]</ref>]] Mutations of the gene GLA influence the enzyme &alpha;-galactosidase A. These mutations can affect the synthesis<ref name=lemansky>Lemansky et al., "Synthesis and processing of alpha-galactosidase A in human fibroblasts. Evidence for different mutations in Fabry disease.", J Biol Chem. 1987 Feb 15, [http://www.ncbi.nlm.nih.gov/pubmed/3029062 PubMed]</ref>, kinetic properties and stability<ref name=bernstein>Bernstein et al., "Fabry disease: six gene rearrangements and an exonic point mutation in the alpha-galactosidase gene.", J Clin Invest 1989 Apr, [http://www.ncbi.nlm.nih.gov/pubmed/2539398 PubMed]</ref> of the enzyme which leads to a decreased enzyme activity. Hence the catabolization of glycosphingolipids is not done properly which is especially the case for the breakdown of globotriaosylceramide (GL3) to lactosylceramide (GL2) and galactose<ref name=nance>Nance et al., "Later-onset Fabry disease: an adult variant presenting with the cramp-fasciculation syndrome.", Arch Neurol. 2006 Mar, [http://www.ncbi.nlm.nih.gov/pubmed/16533976 PubMed]</ref>. The accumulation of the glycosphingolipids leads to the progressively arising symptoms of the Fabry disease. Since the &alpha;-galactosidase A is located in the lysosome, Fabry disease is categorized as an lysosomal storage disorder. === Cross-references === * [http://www.genome.jp/dbget-bin/www_bget?ds:H00125 KEGG: Fabry Disease] * [http://www.genome.jp/kegg-bin/show_pathway?hsa00603+2717 KEGG: Glycosphingolipid biosynthesis] == Mutations == Currently there are 494 mutations known of the GLA gene in HGMD (as of 2011/05/15)<ref name=HGMD>[http://www.hgmd.cf.ac.uk/ac/gene.php?gene=GLA HGMD]</ref>. 492 of these mutations are associated with Fabry disease, for one mutation there is a uncertainty about the association and one mutation leads to an increased transcription of GLA. A great majority (about 70%) of the associated mutations are missense/nonsense mutations. === Reference sequence === * [[alpha_galactosidase_reference_nucleotide|Nucleotide sequence]] * [[alpha_galactosidase_reference_amino_acid|Amino acid sequence]] [[Category:Disease]] == References == <references />

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