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The effect of L-alanine therapy in a patient with adult onset glycogen storage disease type II

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Journal of Inherited Metabolic Disease

Summary

Adult-onset glycogen storage disease type II (GSD II) (McKusick 232300) is a progressive disabling myopathy. At present there is no treatment of proven clinical efficacy. Enzyme replacement therapy may in the future provide benefit but it will be costly and is not yet freely available. L-Alanine, a simple and relatively cheap therapy, has been shown to reduce protein degradation in GSD II patients but has not previously been assessed for clinical benefit in a controlled study. In this study L-alanine was assessed in a double blind, placebo-controlled, crossover n = 1 study. Assessments consisted of spirometry, cardiopulmonary exercise testing, quality of life measurements, biochemical markers and assessment by the criterion 4-component model of body composition. Alanine therapy was associated with a 15% gain in total body protein. However, the patient showed no functional improvement and reported feeling worse after treatment. Further controlled studies in a small group may be warranted, but not widespread use of this therapy.

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References

  • Bodamer OA, Halliday D, Leonard JV (2000) The effects of L-alanine supplementation in late-onset glycogen storage disease type II. Neurology 55(5): 710–712.

    CAS  PubMed  Google Scholar 

  • Demey HE, Van Meerbeeck JP, Vandewoude MF, et al (1989) Respiratory insufficiency in acid maltase deficiency: the effect of high protein diet. JPEN J Parenter Enteral Nutr 13(3): 321–323.

    CAS  PubMed  Google Scholar 

  • Fuller NJ, Jebb SA, Coward WA, Elia M (1992) Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass. Clin Sci (Lond) 82(6): 687–693.

    CAS  Google Scholar 

  • Haroun D, Wells JC, Williams JE, Fuller NJ, Fewtrell MS, Lawson MS (2005) Composition of the fat-free mass in obese and nonobese children: matched case-control analyses. Int J Obes (Lond) 29(1): 29–36.

    CAS  Google Scholar 

  • Hobart JC, Lamping DL, Fitzpatrick R, et al (2000) Measuring the walking ability of people with multiple sclerosis (MS): a novel, patient based, and rigorous 12-item measure. Qual Life Res 9: 286.

    Google Scholar 

  • Jenkinson C, Coulter A, Wright L (1993) Short Form 36 (SF-36) Health survey questionnaire: normative data for adults of working age. BMJ 306: 1437–1440.

    Google Scholar 

  • Posner BN, Cupples LA, Franz MM, Gagnon DR (1993) Diet and heart disease risk factors in adult American men and women: the Framingham Offspring-Spouse nutrition studies. Int J Epidemiol 22(6): 1014–1012.

    CAS  PubMed  Google Scholar 

  • Umpleby AM, Wiles CM, Trend PS, et al (1987) Protein turnover in acid maltase deficiency before and after treatment with a high protein diet. J Neurol Neurosurg Psychiatry 50(5): 587–592.

    CAS  PubMed  Google Scholar 

  • Umpleby AM, Trend PS, Chubb D, et al (1989) The effect of a high protein diet on leucine and alanine turnover in acid maltase deficiency. J Neurol Neurosurg Psychiatry 52(8): 954–961.

    CAS  PubMed  Google Scholar 

  • Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield SB (1999) Hydration of fat-free body mass: review and critique of a classic body-composition constant. Am J Clin Nutr 69(5): 833–841.

    CAS  PubMed  Google Scholar 

  • Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6): 473–483.

    PubMed  Google Scholar 

  • Wells JC, Fuller NJ, Wright A, Fewtrell MS, Cole TJ (2003) Evaluation of air-displacement plethysmography in children aged 5–7 years using a three-component model of body composition. Br J Nutr 90(3): 699–707.

    Article  CAS  PubMed  Google Scholar 

  • Winkel LP, Van den Hout, JM, Kamphoven, et al (2004) Enzyme replacement therapy in late-onset Pompe’s disease: a three-year follow-up. Ann Neurol 55(4): 495–502.

    Article  CAS  PubMed  Google Scholar 

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Communicating editor: Guy Besley

Competing interests: None declared

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Mundy, H.R., Williams, J.E., Cousins, A.J. et al. The effect of L-alanine therapy in a patient with adult onset glycogen storage disease type II. J Inherit Metab Dis 29, 226–229 (2006). https://doi.org/10.1007/s10545-006-0238-7

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  • DOI: https://doi.org/10.1007/s10545-006-0238-7

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