Abstract

Fabry disease is caused by loss of activity of the lysosomal hydrolase α-galactosidase A (GLA). Premature life-threatening complications in Fabry patients arise from cardiovascular disease, including stroke and myocardial infarction. Exercise training has been shown to improve endothelial dysfunction in various settings including coronary artery disease. However, the effects of exercise training on endothelial dysfunction in Fabry disease have not been investigated. Gla knockout mice were single-housed in a cage equipped with a voluntary wheel (EX) or no wheel (SED) for 12 weeks. Exercised mice ran 10 km/day on average during the voluntary running intervention (VR) period. Despite significantly higher food intake in EX than SED, body weights of EX and SED remained stable during the VR period. After the completion of VR, citrate synthase activity in gastrocnemius muscle was significantly higher in EX than SED. VR resulted in greater phosphorylation of Akt (S473) and AMPK (T172) in the aorta of EX compared to SED measured by western blot. Furthermore, VR significantly enhanced eNOS protein expression and phosphorylation at S1177 by 20% and 50% in the aorta of EX when compared with SED. Similarly, plasma nitrate and nitrite levels were 77% higher in EX than SED. In contrast, measures of anti- and pro-oxidative enzymes (superoxide dismutase and p67phox subunit of NADPH oxidase) and overall oxidative stress (plasma oxidized glutathione) were not different between groups. Although the aortic endothelial relaxation to acetylcholine was slightly increased in EX, it did not reach statistical significance. This study provides the first evidence that VR improves Akt/AMPK/eNOS signaling cascades, but not endothelial function in the aorta of aged Gla deficient mice.

Highlights

  • Fabry disease is an X-linked lysosomal storage disorder that results from a defective or absent activity of α-galactosidase A (GLA) [1]

  • Previous research regarding Fabry disease has focused on the pathophysiologic mechanisms using both patients and mouse models [6,7,8, 32,33,34]

  • Few studies have investigated the potential effects of exercise training on endothelial dysfunction in Fabry disease [17]

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Summary

Introduction

Fabry disease is an X-linked lysosomal storage disorder that results from a defective or absent activity of α-galactosidase A (GLA) [1]. The enzymatic defect leads to a progressive accumulation of glycosphingolipids including globotriaosylceramide, galabiosylceramide, and globotriaosylsphingosine. Glycosphingolipid accumulation is observed in a variety of cell types, notably in the endothelium and smooth muscle cells [2, 3]. Symptoms of Fabry disease in childhood include episodic acute pain and gastrointestinal involvement with abdominal pain, diarrhea, and nausea [3]. Whereas enzyme replacement therapy (ERT) with recombinant GLA is a long standing approved treatment for Fabry disease, there is only limited evidence that ERT alters the natural course of cardiovascular morbidities in patients with advanced Fabry disease [5]

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