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12 Notable Krabbe Disease Treatment Options

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Krabbe disease treatment - Krabbe disease is a rare neurological disorder that affects the nervous system. It is caused by a deficiency of the enzyme galactosidase A, which is responsible for breaking down a type of sugar called galactose. This leads to the accumulation of galactose in the tissues and organs, which can damage the cells and tissues.

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Krabbe disease symptoms usually appear in infancy or early childhood. They may include difficulty swallowing and eating, muscle weakness, poor coordination, and seizures. Krabbe disease in adults can lead to death within a few months or years after diagnosis. However, treatment options are available that can improve the prognosis for some patients. There is currently no known cure for Krabbe syndrome.

If a person or their loved one has been diagnosed with Krabbe disease, it is important to learn as much as they can about the condition and seek treatment options. They should talk to their doctor about what treatments may be available to them. There are also several support groups available for people affected by Krabbe disease. The Krabbe Disease Foundation is a good resource for information and support.

Krabbe Disease Causes and Risk Factors

Krabbe syndrome happens when a person inherits two copies of a mutated or altered gene. This means receiving a copy from each parent.

A gene provides a type of map used for producing proteins. If there is a mistake on this map, then the protein product will most likely not function properly. With Krabbe disease, two altered copies of a particular gene result in minimal or no production of an enzyme called galactocerebrosidase (GALC).

Enzymes, such as GALC, carry the responsibility for breaking down certain substances in a cell's recycling center (lysosome). In Krabbe disease, the short supply of GALC enzymes results in the accumulation of certain types of fats called galactolipids.

Galactolipids usually exist in cells that produce the protective coating of nerve cells called myelin. However, the formation of too many galactolipids has a toxic effect. Some galactolipids trigger myelin-forming cells to self-destruct, which in turn causes more problems.

Other galactolipids are taken up by specific debris-eating cells in the nervous system called microglia. The process of cleaning up the excess galactolipids transforms these typically helpful cells into abnormal, toxic cells called globoid cells. These cells promote myelin-damaging inflammation. The subsequent loss of myelin (demyelination) prevents nerve cells from sending and receiving messages.

There is no known way to prevent Krabbe disease from occurring. However, there are some risk factors that may increase the chance of a person developing the condition.

Risk factors for Krabbe disease include:

  • Having a family history of Krabbe disease
  • Being diagnosed with another inherited neurological disorder, such as adrenoleukodystrophy (ALD) or metachromatic leukodystrophy (MLD)
  • Being born prematurely or having a low birth weight
  • Receiving a blood transfusion or organ transplant from someone who has Krabbe disease
  • Exposure to certain environmental toxins, such as mercury or lead
  • Having a viral infection, such as HIV/AIDS or CMV (cytomegalovirus)
  • Being treated with a certain type of chemotherapy called alkylating agents

Krabbe Disease Symptoms

In most cases, the signs and symptoms of Krabbe disease appear during the first 2 to 5 months of life. They begin gradually and progressively worsen.

Krabbe Disease in Children

  • Difficulties with feeding
  • Crying unexplainably
  • Extreme irritability
  • Fever with no sign of infection
  • Decline in alertness
  • Delay in typical developmental milestones
  • Muscle spasms
  • Loss of head control
  • Vomiting frequently

More severe and frequent symptoms appear once the disease starts to progress

  • Seizures
  • Loss of developmental abilities
  • Loss of hearing and sight progressively
  • Constricted and rigid muscles
  • Stiff, fixed posture
  • Loss of ability to swallow and breathe progressively
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Krabbe disease in adults

When Krabbe disease develops later in childhood or during adulthood, signs, and symptoms can vary widely. They may include:

  • Loss of vision progressively
  • Difficulty walking, called ataxia
  • Declination in thinking skills
  • Loss of manual dexterity
  • Weakness in muscles

Krabbe Disease Diagnosis and Treatment

There is no specific Krabbe disease diagnosis test. Diagnosis is based on a combination of clinical symptoms, medical history, and laboratory tests.

One of the main laboratory tests used to help diagnose Krabbe disease is a measure of the level of GALC enzyme activity in the blood or urine. If this enzyme activity is low, it suggests that the person has Krabbe disease.

Other laboratory tests that may be used include a genetic test to look for mutations in the GALC gene, a nerve conduction study, and an MRI (magnetic resonance imaging) scan. Other ways to diagnose Krabbe disease include:

Nerve Conduction Study: A nerve conduction study is a test that measures the speed and strength of electrical signals as they travel along nerves. This test can help determine if there is damage to the myelin sheath that surrounds nerve cells.

The nerve conduction study for Krabbe disease is done by stimulating one nerve with small electrical shocks and then measuring the response of another nerve. If the second nerve does not respond as it should, it suggests that the myelin sheath has been damaged.

Genetic Testing: This is another test that may be done. A genetic test may be performed with a blood sample to figure out a diagnosis. There are variant forms of the altered gene which result in Krabbe disease. The particular type of mutation may provide some information regarding the course of the disease.

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Newborn Screening: A newborn screening test is available to detect infants who are at risk for developing Krabbe disease. The newborn screening test can help identify infants who may need further evaluation for the condition. The initial screening test measures GALC enzyme activity. If the enzyme activity is too low, follow-up GALC tests and genetic tests are conducted.

There is no known cure for Krabbe disease. However, there is Krabbe disease treatment available that can improve the prognosis for some patients. Krabbe disease treatment options vary depending on the stage of the disease and the symptoms exhibited. Treatment options include:

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  • Plasma Exchange Therapy (PEx): This therapy involves removing blood from the person's body, filtering out the harmful substances, and then returning the blood to the body.
  • Intravenous Immunoglobulin (IVIG): This therapy involves giving a person immune globulin intravenously. Immunoglobulin is made up of antibodies that help fight infection.
  • Gene Therapy: This therapy involves replacing the mutated gene with a healthy copy of the gene. This can be done through a number of different methods, such as gene therapy vectors, stem cell transplantation, or bone marrow transplantation.
  • Hospice Care: This is care that is provided to people who are terminally ill, and it focuses on providing comfort and support rather than trying to cure the person's illness.
  • Bone Marrow Transplant: This is the most common and successful treatment for Krabbe disease. A bone marrow transplant involves replacing unhealthy bone marrow with healthy donor bone marrow. This can be done either through a matched sibling donor or an unrelated donor.
  • Enzyme Replacement Therapy: This therapy involves giving patients weekly injections of the enzyme galactosidase A. This helps to break down the galactose in the tissues and organs, which reduces the damage caused by the accumulation of galactose.
  • Shunt Placement: In some cases, doctors may recommend placing a shunt in the brain to help drain excess cerebrospinal fluid. This can help to reduce the amount of pressure on the brain and improve symptoms.
  • Physical Therapy: Physical therapy can help maintain muscle strength and function. It can also help improve communication and movement skills.
  • Corticosteroids: These drugs are used to reduce inflammation.
  • Plasmapheresis: This procedure removes harmful substances from the blood, such as galactolipids and globoid cells.
  • Hearing Aids or Cochlear Implants: These devices may be recommended if hearing loss occurs as a result of demyelination.
  • Support Groups: There are several support groups available for people affected by Krabbe disease. The Krabbe Disease Foundation is a good resource for information and support.

Stem Cell Transplantation for Krabbe Disease

Stem cell transplantation is a treatment option that is being explored for Krabbe disease. Stem cells are cells that have the potential to develop into many different types of cells in the body. There are two basic types of stem cells: embryonic stem cells and adult stem cells. Embryonic stem cells are derived from embryos that are four to five days old. These stem cells have the ability to turn into any type of cell in the body. Adult stem cells are found in adults and they can only turn into specific types of cells.

Stem cell transplantation involves transferring stem cells from one person to another. The goal is to transplant healthy stem cells into a person who has Krabbe disease in order to replace the unhealthy cells. Stem cell transplantation has been successful in treating other diseases, such as leukemia and lymphoma. However, it is still an experimental treatment for Krabbe disease and more research is needed to determine its effectiveness.

There are several different methods of stem cell transplantation that can be used:

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  • Autologous Stem Cell Transplantation: This is the most common type of stem cell transplantation. It involves transferring stem cells from the person's own body to the bloodstream.
  • Allogeneic Stem Cell Transplantation: This type of transplant involves transferring stem cells from a donor's bloodstream into the person's bloodstream. The donor must be a matched sibling or an unrelated donor.
  • Umbilical Cord Stem Cell Transplantation: This is a newer type of transplant that involves transferring stem cells from the umbilical cord of a newborn baby.
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