P.3.052 - First episode schizophrenia: Treatment and outcome

Abstract

This chapter discusses the late-onset GM2 gangliosidosis and other Hexosaminidase mutation among Jews. Tay-Sachs Disease (TSD) is caused by absence of β-hexosaminidase (Hex) A, following which heat inactivation method (HIM) for quantifying Hex A using the synthetic substrate 4-MUG. The interaction between Hex A and GM2 ganglioside substrate is accomplished by a nonenzymatic protein, the GM2 activator. Hex A-deficient adults have residual Hex A activity that are significantly higher in TSD patients, but significantly lower than in TSD heterozygotes. AGG is a slowly progressing neurodegenerative disorder. The patients have very low Hex A activity and usually carry the Gly269Ser mutation in compound heterozygosity with an infantile TSD mutation. Homozygotes for the Gly269Ser mutation are only mildly affected. The enzyme β-hexosaminidase (Hex) B does not degrade the GM2 ganglioside in humans, and therefore has no direct involvement in TSD. However, it is a major participant in the routine enzymatic assay for identification of TSD genotypes because Hex B, like Hex A, hydrolyzes the synthetic substrate 4-MUG, and, unlike Hex A, it is heat stabile. It is estimated that 1 in 140 Moroccans is a TSD carrier, and seven different TSD mutations in this community have been identified.