Language and speech function in children with infantile Pompe disease

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2009-01-01

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Abstract

Pompe disease, also known as glycogen storage disease type II and acid maltase deficiency, is a rare autosomal recessive progressive neuromuscular disorder. The natural course of the infantile form of this condition has resulted in mortality for patients prior to 1 year of age, making investigations into language and speech function in this population impossible. However, with the advent of treatment with enzyme replacement therapy (ERT) using alglucosidase alfa (Myozyme®), the lifespan of children with this condition has been extended. A retrospective study of the language and speech skills of 12 children enrolled in clinical trials for treatment with ERT at a tertiary care center was completed. Standardized language assessment instruments were administered to all participants, and six of the 12 were assessed twice. At initial assessment, overall language function was found to be age appropriate in 58% of participants, while, in those who received reassessment, overall normal language function was seen in 83%. Speech assessments were completed during all visits in which subjects were 24 months or older. Articulatory disorders and/or hypernasality were commonly encountered and were exhibited in 82% of speech assessments. Disorders in language and/or speech were found in all participants at some point in the course of the study. Overall, language delays tended to improve with time. Speech disorders were encountered more commonly, were often severe, and appeared to be motoric in nature. Children with infantile Pompe disease treated with ERT appear to be at high risk for speech disorders in particular. Further systematic investigations are needed. © 2009 IOS Press. All rights reserved.

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10.3233/JPN-2009-0291

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Muller, CW, HN Jones, G O'Grady, HA Suárez, JH Heller and PS Kishnani (2009). Language and speech function in children with infantile Pompe disease. Journal of Pediatric Neurology, 7(2). pp. 147–156. 10.3233/JPN-2009-0291 Retrieved from https://hdl.handle.net/10161/27323.

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Scholars@Duke

Jones

Harrison N. Jones

Associate Professor of Head and Neck Surgery & Communication Sciences
Kishnani

Priya Sunil Kishnani

Chen Family Distinguished Professor of Pediatrics

RESEARCH INTERESTS

A multidisciplinary approach to care of individuals with genetic disorders in conjunction with clinical and bench research that contributes to:
1) An understanding of the natural history and delineation of long term complications of genetic disorders  with a special focus on liver Glycogen storage disorders, lysosomal disorders with a special focus on Pompe disease, Down syndrome and hypophosphatasia
2) ) The development of new therapies such as AAV gene therapy, enzyme therapy, small molecule and other approaches for genetic disorders through translational research

3) The development and execution of large multicenter trials to confirm safety and efficacy of potential therapies
4) Role of antibodies/immune response in patients on therapeutic proteins and AAV gene therapy

. Glycogen Storage Disease (GSD): We are actively following subjects with all types of Glycogen Storage Disease, with particular emphasis on types I, II, III, IV, VI and IX. The goal of the treatment team is to better determine the clinical phenotype and long term complications of these diseases. Attention to disease manifestations observed in adulthood, such as adenomas and risk for HCC, is of paramount importance in monitoring and treating these chronic illnesses. We are establishing clinical algorithms for managing adenomas, and the overall management of these patients including cardiac, bone, muscle and liver issues. A special focus is biomarker discovery, an Omics approach including metabolomics and immune phenotyping. We are working on AAV gene therapy for several hepatic GSDs

.Lysosomal Storage Disease: The Duke Lysosomal Storage Disease (LSD) treatment center follows and treats patients with Pompe, Gaucher, Fabry, Mucopolysaccharidosis, Niemann Pick, LAL-D and other LSD's. The Duke Metabolism Clinical Research Team is exploring many aspects of enzyme replacement therapy (ERT), including impact on different systems, differential response, and long term effects. Other symptomatic and treatment interventions for this category of diseases are also being explored in the context of clinical care.

. Pompe Disease: The care team has extensive experience in the care of infants and adults with Pompe disease and was instrumental in conducting clinical trials and the bench to bedside work that led to the 2006 FDA approval of alglucosidase alfa, the first treatment for this devastating disease. We are currently focusing on role of antibodies/immune response on patient outcome and role of immune modulation/immune suppression as an adjunct to ERT. Our team is also working on AAV gene therapy for Pompe disease. A focus is on newborn screening (NBS) and understanding the clinical phenotype and management approaches for babies identified via NBS

.  Hypophosphatasia: We follow a large cohort of patients with HPP. The goal is to understand the features of the disease beyond bone disease, development of biomarkers, role of ERT and immune responses in HPP

. Neuromuscular disorders: We are collaborating with neurologists, cardiologists and neuromuscular physicians to serve as a treatment site for clinical trials in these diseases. We are currently involved in trials of DMD and are working closely on setting up collaborations for studies in SMA.


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