Status and frontiers of Fabre disease

Abstract Fabry disease is characterized by an X sex chromosome gene mutation caused by α-galactosidase A deficiency, resulting in the accumulation of globotriaosylceramide and globotriaosylsphingosine in various organs, which induces end-organ lesions. In Fabry disease, enzymes with lost or decrease...

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Main Authors: Wei Chu, Min Chen, Xiaoqin Lv, Sheng Lu, Changyan Wang, Limin Yin, Linyan Qian, Jiana Shi
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Orphanet Journal of Rare Diseases
Subjects:
Online Access:https://doi.org/10.1186/s13023-025-03646-y
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author Wei Chu
Min Chen
Xiaoqin Lv
Sheng Lu
Changyan Wang
Limin Yin
Linyan Qian
Jiana Shi
author_facet Wei Chu
Min Chen
Xiaoqin Lv
Sheng Lu
Changyan Wang
Limin Yin
Linyan Qian
Jiana Shi
author_sort Wei Chu
collection DOAJ
description Abstract Fabry disease is characterized by an X sex chromosome gene mutation caused by α-galactosidase A deficiency, resulting in the accumulation of globotriaosylceramide and globotriaosylsphingosine in various organs, which induces end-organ lesions. In Fabry disease, enzymes with lost or decreased activity in the body are replaced by exogenous supplementation of normal-function α-galactosidase A. Currently, agalsidase α and agalsidase β are widely used for ERT therapy. However, this therapy has limitations such as high cost, short half-life, and production of neutralizing drug antibodies. The use of Migalastat as chaperone therapy has been approved in many countries, and it plays a therapeutic role by enhancing enzyme activity. However, companion therapy drugs are only suitable for patients with decreased enzyme activity, so the scope of their application is limited. In addition, there are several therapeutic drugs in development, including a new generation of ERT therapies, drugs resistant to neutralizing anti-drug antibody drugs, and substrate reduction therapy drugs. Due to the limitations of existing therapeutic drugs, researchers have begun to explore new therapeutic drugs for Fabry disease, so new pathogenic mechanisms and adjuvant therapeutic drugs have been continuously discovered, and the development of related drugs will contribute to disease control and treatment. This article summarizes the existing and potential drugs for treating Fabry disease to facilitate the selection of suitable and effective drugs for treatment.
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spelling doaj-art-2ff878e5f49f47b49c39d42db40fe02e2025-08-20T03:01:41ZengBMCOrphanet Journal of Rare Diseases1750-11722025-03-012011710.1186/s13023-025-03646-yStatus and frontiers of Fabre diseaseWei Chu0Min Chen1Xiaoqin Lv2Sheng Lu3Changyan Wang4Limin Yin5Linyan Qian6Jiana Shi7Department of Pharmacy, The First People’s Hospital of Huzhou, The Directly Affiliated Hospital of Huzhou Teachers CollegeCenter for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Department of Drug Monitoring and Evaluation, Zhejiang Center for Drug and Cosmetic EvaluationDepartment of Pharmacy, The First People’s Hospital of Huzhou, The Directly Affiliated Hospital of Huzhou Teachers CollegeDepartment of Clinical Laboratory, Huzhou Aishan Hospital of Integrated Chinese and Western MedicineDepartment of Pharmacy, First People’s Hospital of WenlingCenter for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College)Abstract Fabry disease is characterized by an X sex chromosome gene mutation caused by α-galactosidase A deficiency, resulting in the accumulation of globotriaosylceramide and globotriaosylsphingosine in various organs, which induces end-organ lesions. In Fabry disease, enzymes with lost or decreased activity in the body are replaced by exogenous supplementation of normal-function α-galactosidase A. Currently, agalsidase α and agalsidase β are widely used for ERT therapy. However, this therapy has limitations such as high cost, short half-life, and production of neutralizing drug antibodies. The use of Migalastat as chaperone therapy has been approved in many countries, and it plays a therapeutic role by enhancing enzyme activity. However, companion therapy drugs are only suitable for patients with decreased enzyme activity, so the scope of their application is limited. In addition, there are several therapeutic drugs in development, including a new generation of ERT therapies, drugs resistant to neutralizing anti-drug antibody drugs, and substrate reduction therapy drugs. Due to the limitations of existing therapeutic drugs, researchers have begun to explore new therapeutic drugs for Fabry disease, so new pathogenic mechanisms and adjuvant therapeutic drugs have been continuously discovered, and the development of related drugs will contribute to disease control and treatment. This article summarizes the existing and potential drugs for treating Fabry disease to facilitate the selection of suitable and effective drugs for treatment.https://doi.org/10.1186/s13023-025-03646-yFabry diseaseTherapeutic drugsERT
spellingShingle Wei Chu
Min Chen
Xiaoqin Lv
Sheng Lu
Changyan Wang
Limin Yin
Linyan Qian
Jiana Shi
Status and frontiers of Fabre disease
Orphanet Journal of Rare Diseases
Fabry disease
Therapeutic drugs
ERT
title Status and frontiers of Fabre disease
title_full Status and frontiers of Fabre disease
title_fullStr Status and frontiers of Fabre disease
title_full_unstemmed Status and frontiers of Fabre disease
title_short Status and frontiers of Fabre disease
title_sort status and frontiers of fabre disease
topic Fabry disease
Therapeutic drugs
ERT
url https://doi.org/10.1186/s13023-025-03646-y
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AT shenglu statusandfrontiersoffabredisease
AT changyanwang statusandfrontiersoffabredisease
AT liminyin statusandfrontiersoffabredisease
AT linyanqian statusandfrontiersoffabredisease
AT jianashi statusandfrontiersoffabredisease