Galactosemia medical therapy: Difference between revisions

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{{Galactosemia}}
{{Galactosemia}}
{{CMG}}; {{AE}} {{DD}}
{{CMG}}; {{AE}} {{Sujaya}}


==Overview==
==Overview==
 
[[Medical]] therapy is of limited importance in [[galactosemia]].


==Medical Therapy==
==Medical Therapy==
The only proven to be efficient treatment for galactosemia is elimination of all galactose containing foods, this would mean limiting all dairy products to zero and all traces of dairy in other foods.
The main [[medical]] [[treatments]] currently being applied are:
* '''[[Galactokinase]] 1 ([[GALK1]]) [[inhibitors]]'''<ref name="pmid12705493">{{cite journal| author=Bosch AM, Bakker HD, van Gennip AH, van Kempen JV, Wanders RJ, Wijburg FA| title=Clinical features of galactokinase deficiency: a review of the literature. | journal=J Inherit Metab Dis | year= 2002 | volume= 25 | issue= 8 | pages= 629-34 | pmid=12705493 | doi=10.1023/a:1022875629436 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12705493  }} </ref>: These compounds reduce the accumulation of [[Galactose-1-phosphate]], the major mediator of the [[pathogenic]] effects of [[GALT]] [[deficiency]] [[galactosemia]]<ref name="pmid31808946">{{cite journal| author=Haskovic M, Coelho AI, Bierau J, Vanoevelen JM, Steinbusch LKM, Zimmermann LJI | display-authors=etal| title=Pathophysiology and targets for treatment in hereditary galactosemia: A systematic review of animal and cellular models. | journal=J Inherit Metab Dis | year= 2020 | volume= 43 | issue= 3 | pages= 392-408 | pmid=31808946 | doi=10.1002/jimd.12202 | pmc=7317974 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31808946  }} </ref>. Moreover, [[GALK1]] is highly [[substrate]] specific, thereby eliminating undesirable [[interactions]]<ref name="pmid20696150">{{cite journal| author=Tang M, Wierenga K, Elsas LJ, Lai K| title=Molecular and biochemical characterization of human galactokinase and its small molecule inhibitors. | journal=Chem Biol Interact | year= 2010 | volume= 188 | issue= 3 | pages= 376-85 | pmid=20696150 | doi=10.1016/j.cbi.2010.07.025 | pmc=2980576 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20696150  }} </ref>.


Immediate stopping of all galactose containing foods in individuals with GALT enzyme activity of less than 10% and whose red blood count or RBC galactose-1-phosphate is greater than 10mg/dl. All infant formulas should be replaced with soy formulas that contain sucrose, fructose and non galactose polycarbohydrates. Elimination of galactose containing foods should be a lifelong treatment.
==References==
 
After early life and childhood, milk becomes a less important part of life and hence managing the galactose free diet, however at this stage it was noted that despite avoidance of exogenous galactose, the production of endogenous galactose results in an increase of the enzyme gal-1-P. It is due to ingestion of foods contaminated with some dairy such as breads, biscuits, soups, cereals etc.
 
Individuals with the Duarte variant form of galactosemia do not need to be strict about galactose elimination, however they do need to avoid milk and ingest moderate amounts of galactose.


Continued monitoring of the accumulation of toxic RBC gal-1-P and urinary galactitol should be carried throughout life. If sudden increases are detected, other tests and evaluations should be carried especially for infection and sepsis. Ophtalmologic examination, developmental evaluation and speech development focusing should be done
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 11:06, 5 July 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]

Overview

Medical therapy is of limited importance in galactosemia.

Medical Therapy

The main medical treatments currently being applied are:

References

  1. Bosch AM, Bakker HD, van Gennip AH, van Kempen JV, Wanders RJ, Wijburg FA (2002). "Clinical features of galactokinase deficiency: a review of the literature". J Inherit Metab Dis. 25 (8): 629–34. doi:10.1023/a:1022875629436. PMID 12705493.
  2. Haskovic M, Coelho AI, Bierau J, Vanoevelen JM, Steinbusch LKM, Zimmermann LJI; et al. (2020). "Pathophysiology and targets for treatment in hereditary galactosemia: A systematic review of animal and cellular models". J Inherit Metab Dis. 43 (3): 392–408. doi:10.1002/jimd.12202. PMC 7317974 Check |pmc= value (help). PMID 31808946.
  3. Tang M, Wierenga K, Elsas LJ, Lai K (2010). "Molecular and biochemical characterization of human galactokinase and its small molecule inhibitors". Chem Biol Interact. 188 (3): 376–85. doi:10.1016/j.cbi.2010.07.025. PMC 2980576. PMID 20696150.

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