Canavan disease is an inherited disorder that causes progressive damage to nerve cells in the brain. This disease is one of a group of genetic disorders called leukodystrophies. Leukodystrophies are characterized by degeneration of myelin, which is the phospholipid layer covering that insulates nerve fibers.
Epidemiology
Although Canavan disease may occur in any ethnic group, it affects persons of
Eastern European
Jewish ancestry more frequently. About 1/40 individuals of
Eastern European (
Ashkenazi)
Jewish ancestry are carriers, about 1:10,000. Canavan disease is inherited in an autosomal recessive fashion. If both parents are carriers, there is a 25% chance to have an affected child.
Genetic counseling and
genetic testing is recommended for families who may be carriers.
Cause
Canavan disease is caused by a defective
ASPA gene, responsible for the production of the
enzyme aspartoacylase. This enzyme breaks down the
n-acetyl-asparate acid, which is a toxin. With decreased levels of aspartoacylase comes an increase in n-acetyl-aspartate, which interferes with growth of the
myelin sheath of the
nerve fibers in the brain. The myelin sheath is the
fatty covering surrounding nerve cells that acts as an
insulator, and allows for efficient transmission of
nerve impulses.
Symptoms
Symptoms of Canavan disease, which appear in early
infancy and progress rapidly, may include
mental retardation, loss of previously acquired
motor skills, feeding difficulties, abnormal
muscle tone (i.e., floppiness or stiffness), poor head control, and
megalocephaly (abnormally enlarged head).
Paralysis,
blindness, or
seizures may also occur.
Treatment
There is no cure for Canavan disease, nor is there a standard course of treatment. Treatment is symptomatic and supportive. The life expectancy of Canavan patients is not known because new treatments have extended their lives beyond earlier projections. Today, Canavan children often survive into their
teens and beyond. Until recently, there was absolutely no hope for Canavan children.
Current research
Paola Leone,
Ph.D. and her team are the only researchers in the entire world working directly with Canavan children. Dr. Leone and her team have pioneered a brain gene therapy to halt the progression of the
disease. Their research offers a glimpse at treating and eventually
eradicating similar degenerative diseases of the brain, such as
Parkinson's disease,
Alzheimer's disease,
Lou Gehrig's disease (ALS), and
Multiple Sclerosis.
Dr. Leone and her team are currently at the University of Medicine and Dentistry of New Jersey, in Camden, New Jersey. The brain gene therapy is conducted at Cooper University Hospital. The procedure involves the insertion of six catheters into the brain that deliver a solution containing 600 billion to 900 billion engineered virus particles. The virus, a modified version of AAV, is designed to replace the aspartoacylase enzyme. Children treated with this procedure to date have shown marked improvements, including the growth of myelin with decreased levels of the n-acetyl-aspartate toxin.
- An earlier version of this article was based on material from http://www.ninds.nih.gov/health_and_medical/disorders/canavn_doc.htm
External links
Eponymous diseases | Genetic disorders | Leukodystrophies | Lysosomal storage diseases
Maladie de Canavan