1. LC-MS lipidomics of renal biopsies for the diagnosis of Fabry disease
- Author
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Hoda Safari Yazd, Sina Feizbakhsh Bazargani, Christine A. Vanbeek, Kelli King-Morris, Coy Heldermon, Mark S. Segal, Richard Yost, William L. Clapp, and Timothy J. Garrett
- Subjects
medicine.medical_specialty ,Pathology ,CAN, Acetonitrile ,MS/MS, Tandem Mass Spectrometry ,OCT, Optimal Cutting Temperature ,CDH, Cerebrodihexoside ,LC/MS, Liquid Chromatography-Mass Spectrometry ,UHPLC-HRMS, Ultra-High Pressure Liquid Chromatography-High-Resolution Mass Spectrometry ,Clinical Biochemistry ,Globotriaosylceramide ,Cnvs, Copy Number Variants ,Microbiology ,Special issue on Lipidomics ,chemistry.chemical_compound ,ERT, Enzyme Replacement Therapy ,Liquid chromatography–mass spectrometry ,Ga2, Galabiosylceramide ,Biopsy ,Lipidomics ,Medical technology ,medicine ,R855-855.5 ,GLA, Glactosidase Alpha ,SRM, Selected Reaction Monitoring ,Spectroscopy ,EIC, Extracted Ion Chromatogram ,ND, Not Detected ,Kidney ,Clinical pathology ,medicine.diagnostic_test ,business.industry ,Gb3, Globotriaosylceramide ,SECIM, Southeast Center for Integrated Metabolomics ,medicine.disease ,Fabry disease ,Chcl3, Chloroform ,α-GAL A, α-Galactosidase A ,Lyso-Gb3, Globotriaosylsphingosine ,Medical Laboratory Technology ,medicine.anatomical_structure ,chemistry ,IPA, 2-Propanol ,Renal biopsy ,Meoh, Methanol ,business ,LSD, Lysosomal Storage Disorder - Abstract
Highlights • Fabry is an X-linked lysosomal storage disease with deficiency in α-galactosidase. • This deficiency results in the accumulation of glycosphinogolipids. • Diagnosis is often made by analysis of globotriaosylceramide in fluids and tissues. • Fabry is often misdiagnosed in female patients due to residual enzyme activity. • Lipidomics by LC-HRMS enables identification of new biomarkers in Fabry., Introduction Lipidomics analysis or lipid profiling is a system-based analysis of all lipids in a sample to provide a comprehensive understanding of lipids within a biological system. In the last few years, lipidomics has made it possible to better understand the metabolic processes associated with several rare disorders and proved to be a powerful tool for their clinical investigation. Fabry disease is a rare X-linked lysosomal storage disorder (LSD) caused by a deficiency in α-galactosidase A (α-GAL A). This deficiency results in the progressive accumulation of glycosphingolipids, mostly globotriaosylceramide (Gb3), globotriaosylsphingosine (lyso-Gb3), as well as galabiosylceramide (Ga2) and their isoforms/analogs in the vascular endothelium, nerves, cardiomyocytes, renal glomerular podocytes, and biological fluids. Objectives The primary objective of this study was to evaluate lipidomic signatures in renal biopsies to help understand variations in Fabry disease markers that could be used in future diagnostic tests. Methods Lipidomic analysis was performed by ultra-high pressure liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS) on kidney biopsies that were left over after clinical pathology analysis to diagnose Fabry disease. Results We employed UHPLC-HRMS lipidomics analysis on the renal biopsy of a patient suspicious for Fabry disease. Our result confirmed α-GAL A enzyme activity declined in this patient since a Ga2-related lipid biomarker was substantially higher in the patient's renal tissue biopsy compared with two controls. This suggests this patient has a type of LSD that could be non-classical Fabry disease. Conclusion This study shows that lipidomics analysis is a valuable tool for rare disorder diagnosis, which can be conducted on leftover tissue samples without disrupting normal patient care.
- Published
- 2021
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