Journal of Inherited Metabolic Disease

, Volume 15, Issue 1, pp 25–37 | Cite as

Attempted enzyme replacement using human amnion membane implantations in mucopolysaccharidoses

  • J. Muenzer
  • E. F. Neufeld
  • G. Constantopoulos
  • R. C. Caruso
  • M. I. Kaiser-Kupfer
  • A. Pikus
  • J. Danoff
  • R. R. Berry
  • H. D. McDonald
  • J. N. Thompson
  • L. Rodén
  • M. A. Zasloff
Article

Summary

Amnion membrane implantation has been proposed as an approach to enzyme replacement in mucopolysaccharidoses. Human amnion membranes have been subcutaneously implanted in the abdominal wall in 19 patients with mucopolysaccharidoses (MPS I, II and III). A protocol was developed for the objective evaluation of experimental treatments of these patients. Systematic evaluation of the clinical status before and 6 months after amnion membrane implantation reveals no change in function except improvement in joint mobility. The sum of all joint movements showed improvement from baseline values to 6 months after implantation by ANOVA followed bypost-hoc analysis (p<0.056). The only specific joint movements to significantly improve after 6 months were shoulder extension (p<0.01) and hip internal rotation (p<0.05). Serial measurements of the deficient lysosomal enzyme activity in serum and white blood cells did not increase in any patient after amnion membrane implantation. Urinary glycosaminoglycan excretion decreased transiently in 2 of 10 patients after implantation, but a second amnion membrane implantation did not result in any change. Biopsy of the implantation site in 10 patients 6 months after amnion membrane implantation revealed a foreign-body reaction with giant cell formation and fibrosis and no recognizable amnion membrane tissue. We conclude that human amnion membrane implantation is not an effective therapy in mucopolysaccharidoses.

Keywords

Giant Cell Internal Rotation Glycosaminoglycan Lysosomal Enzyme Joint Movement 

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Copyright information

© SSIEM and Kluwer Academic Publishers 1992

Authors and Affiliations

  • J. Muenzer
    • 1
  • E. F. Neufeld
    • 2
  • G. Constantopoulos
    • 3
  • R. C. Caruso
    • 4
  • M. I. Kaiser-Kupfer
    • 4
  • A. Pikus
    • 5
  • J. Danoff
    • 6
  • R. R. Berry
    • 6
  • H. D. McDonald
    • 7
  • J. N. Thompson
    • 8
  • L. Rodén
    • 8
  • M. A. Zasloff
    • 1
  1. 1.Human Genetics BranchNational Institute of Child Health and Human DevelopmentUSA
  2. 2.Genetics and Biochemistry BranchNational Institute of Diabetes, Digestive and Kidney DiseasesUSA
  3. 3.Developmental and Metabolic Neurology BranchNational Institute of Neurological and Communicative Disorders and StrokeUSA
  4. 4.Ophthalmic Genetics and Clinical Services BranchNational Eye InstituteUSA
  5. 5.AudiologyUSA
  6. 6.Rehabilitation Medicine Departments, Warren Grant Magnuson Clinical CenterNational Institutes of HealthUSA
  7. 7.Surgery Branch, Division of Cancer TreatmentNational Cancer Institute, National Institutes of HealthBethesdaUSA
  8. 8.Laboratory of Medical GeneticsUniversity of AlabamaBirminghamUSA

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