Liver and skin histopathology in adults with acid sphingomyelinase deficiency (niemann-pick disease type B)

Beth L. Thurberg, Melissa P. Wasserstein, Thomas Schiano, Fanny O'Brien, Susan Richards, Gerald F. Cox, Margaret M. McGovern

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Acid sphingomyelinase deficiency (ASMD) is a lysosomal storage disorder characterized by the pathologic accumulation of sphingomyelin (SM) in multiple cell types, and occurs most prominently within the liver, spleen, and lungs, leading to significant clinical disease. Seventeen ASMD patients underwent a liver biopsy during baseline screening for a phase 1 trial of recombinant human acid sphingomyelinase (rhASM) in adults with Niemann-Pick disease type B. Eleven of the 17 were enrolled in the trial and each received a single dose of rhASM and underwent a repeat liver biopsy on day 14. Biopsies were evaluated for fibrosis, SM accumulation, and macrophage infiltration by light and electron microscopy. When present, fibrosis was periportal and pericellular, predominantly surrounding affected Kupffer cells. Two baseline biopsies exhibited frank cirrhosis. SM was localized to isolated Kupffer cells in mildly affected biopsies and was present in both Kupffer cells and hepatocytes in more severely affected cases. Morphometric quantification of SM storage in liver biopsies ranged from 4% to 44% of the microscopic field. Skin biopsies were also performed at baseline and day 14 to compare the SM distribution in a peripheral tissue with that of liver. SM storage was present at lower levels in multiple cell types of the skin, including dermal fibroblasts, macrophages, vascular endothelial cells, vascular smooth muscle cells, and Schwann cells. This phase 1 trial of rhASM in adults with ASMD provided a unique opportunity for a prospective assessment of hepatic and skin pathology in this rare disease and their potential usage as pharmacodynamic biomarkers.

Original languageEnglish (US)
Pages (from-to)1234-1246
Number of pages13
JournalAmerican Journal of Surgical Pathology
Volume36
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Type B Niemann-Pick Disease
Type A Niemann-Pick Disease
Sphingomyelins
Biopsy
Skin
Acids
Liver
Sphingomyelin Phosphodiesterase
Kupffer Cells
Fibrosis
Macrophages
Schwann Cells
Rare Diseases
Vascular Smooth Muscle
Smooth Muscle Myocytes
Hepatocytes
Electron Microscopy
Spleen
Endothelial Cells
Fibroblasts

Keywords

  • acid sphingomyelinase deficiency
  • hepatosplenomegaly
  • lysosomal storage disease
  • Niemann-Pick disease
  • sphingomyelin

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Liver and skin histopathology in adults with acid sphingomyelinase deficiency (niemann-pick disease type B). / Thurberg, Beth L.; Wasserstein, Melissa P.; Schiano, Thomas; O'Brien, Fanny; Richards, Susan; Cox, Gerald F.; McGovern, Margaret M.

In: American Journal of Surgical Pathology, Vol. 36, No. 8, 08.2012, p. 1234-1246.

Research output: Contribution to journalArticle

Thurberg, Beth L. ; Wasserstein, Melissa P. ; Schiano, Thomas ; O'Brien, Fanny ; Richards, Susan ; Cox, Gerald F. ; McGovern, Margaret M. / Liver and skin histopathology in adults with acid sphingomyelinase deficiency (niemann-pick disease type B). In: American Journal of Surgical Pathology. 2012 ; Vol. 36, No. 8. pp. 1234-1246.
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