Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder

ABSTRACT Lysosomal free sialic acid storage disorder (FSASD) is a rare, multisystem neurodegenerative disease caused by biallelic pathogenic variants in SLC17A5, encoding sialin. FSASD is characterized by aberrant accumulation of unconjugated “free” sialic acid (Neu5Ac) within lysosomes. Depending o...

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Main Authors: Marya S. Sabir, Laura Pollard, Lynne Wolfe, David R. Adams, Carla Ciccone, Petcharat Leoyklang, Frances M. Platt, Marjan Huizing, William A. Gahl, May Christine V. Malicdan
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:JIMD Reports
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Online Access:https://doi.org/10.1002/jmd2.70029
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author Marya S. Sabir
Laura Pollard
Lynne Wolfe
David R. Adams
Carla Ciccone
Petcharat Leoyklang
Frances M. Platt
Marjan Huizing
William A. Gahl
May Christine V. Malicdan
author_facet Marya S. Sabir
Laura Pollard
Lynne Wolfe
David R. Adams
Carla Ciccone
Petcharat Leoyklang
Frances M. Platt
Marjan Huizing
William A. Gahl
May Christine V. Malicdan
author_sort Marya S. Sabir
collection DOAJ
description ABSTRACT Lysosomal free sialic acid storage disorder (FSASD) is a rare, multisystem neurodegenerative disease caused by biallelic pathogenic variants in SLC17A5, encoding sialin. FSASD is characterized by aberrant accumulation of unconjugated “free” sialic acid (Neu5Ac) within lysosomes. Depending on the specific genetic variants, affected individuals may present with either a rapidly fatal disease or progressive neurodegeneration. While skin fibroblasts have traditionally been used for diagnosis and research, the use of leukocytes in FSASD remains underexplored. This study examined Neu5Ac levels in leukocytes from three individuals with FSASD carrying distinct SLC17A5 variants. The levels in affected individuals were compared to three different groups: (1) the unaffected biological parents of each case; (2) subjects for whom 14 distinct lysosomal storage disorders (LSDs) were excluded based on enzyme analysis (n = 11); and (3) participants with a confirmed LSD diagnosis, as determined by enzyme analysis (n = 9). Individuals with FSASD exhibited significantly higher levels of free Neu5Ac compared to their unaffected biological parents (36‐fold), LSD‐negative subjects (22‐fold), and individuals with other LSDs (49‐fold). Although total Neu5Ac levels showed a non‐significant trend toward an increase in FSASD (1.3‐fold), this was primarily due to elevated free Neu5Ac, as bound Neu5Ac was slightly decreased in the leukocytes of FSASD cases relative to their unaffected parents. Overall, these findings highlight leukocytes as a valuable, minimally invasive cellular model for FSASD, offering an alternative, reliable diagnostic tool and a potential platform for monitoring therapeutic responses in future intervention trials.
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spelling doaj-art-869e228cf74e40dbbc6b0063e4d6d2cd2025-08-20T03:08:40ZengWileyJIMD Reports2192-83122025-07-01664n/an/a10.1002/jmd2.70029Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage DisorderMarya S. Sabir0Laura Pollard1Lynne Wolfe2David R. Adams3Carla Ciccone4Petcharat Leoyklang5Frances M. Platt6Marjan Huizing7William A. Gahl8May Christine V. Malicdan9NIH Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USABiochemical Genetics Laboratory Greenwood Genetic Center Greenwood South Carolina USANIH Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USANIH Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USAHuman Biochemical Genetics Section, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USAHuman Biochemical Genetics Section, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USADepartment of Pharmacology University of Oxford Oxford UKHuman Biochemical Genetics Section, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USANIH Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USANIH Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USAABSTRACT Lysosomal free sialic acid storage disorder (FSASD) is a rare, multisystem neurodegenerative disease caused by biallelic pathogenic variants in SLC17A5, encoding sialin. FSASD is characterized by aberrant accumulation of unconjugated “free” sialic acid (Neu5Ac) within lysosomes. Depending on the specific genetic variants, affected individuals may present with either a rapidly fatal disease or progressive neurodegeneration. While skin fibroblasts have traditionally been used for diagnosis and research, the use of leukocytes in FSASD remains underexplored. This study examined Neu5Ac levels in leukocytes from three individuals with FSASD carrying distinct SLC17A5 variants. The levels in affected individuals were compared to three different groups: (1) the unaffected biological parents of each case; (2) subjects for whom 14 distinct lysosomal storage disorders (LSDs) were excluded based on enzyme analysis (n = 11); and (3) participants with a confirmed LSD diagnosis, as determined by enzyme analysis (n = 9). Individuals with FSASD exhibited significantly higher levels of free Neu5Ac compared to their unaffected biological parents (36‐fold), LSD‐negative subjects (22‐fold), and individuals with other LSDs (49‐fold). Although total Neu5Ac levels showed a non‐significant trend toward an increase in FSASD (1.3‐fold), this was primarily due to elevated free Neu5Ac, as bound Neu5Ac was slightly decreased in the leukocytes of FSASD cases relative to their unaffected parents. Overall, these findings highlight leukocytes as a valuable, minimally invasive cellular model for FSASD, offering an alternative, reliable diagnostic tool and a potential platform for monitoring therapeutic responses in future intervention trials.https://doi.org/10.1002/jmd2.70029leukocyteslysosomal storage disordersSalla diseasesialic acidsialinSLC17A5
spellingShingle Marya S. Sabir
Laura Pollard
Lynne Wolfe
David R. Adams
Carla Ciccone
Petcharat Leoyklang
Frances M. Platt
Marjan Huizing
William A. Gahl
May Christine V. Malicdan
Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder
JIMD Reports
leukocytes
lysosomal storage disorders
Salla disease
sialic acid
sialin
SLC17A5
title Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder
title_full Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder
title_fullStr Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder
title_full_unstemmed Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder
title_short Investigating the Utility of Leukocyte Sialic Acid Measurements in Lysosomal Free Sialic Acid Storage Disorder
title_sort investigating the utility of leukocyte sialic acid measurements in lysosomal free sialic acid storage disorder
topic leukocytes
lysosomal storage disorders
Salla disease
sialic acid
sialin
SLC17A5
url https://doi.org/10.1002/jmd2.70029
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