Potential patient screening for late-onset Pompe disease in suspected sleep apnea: a rationale and study design for a Prospective Multicenter Observational Cohort Study in Japan (PSSAP-J Study).


Journal

Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Titre abrégé: Sleep Breath
Pays: Germany
ID NLM: 9804161

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 12 07 2020
accepted: 10 08 2020
revised: 06 08 2020
pubmed: 19 8 2020
medline: 21 12 2021
entrez: 19 8 2020
Statut: ppublish

Résumé

Pompe disease is an autosomal recessive disorder caused by deficiency of the acid α-glucosidase (GAA) enzyme. GAA deficiency induces progressive glycogen accumulation which leads to weakness of the respiratory muscle including the diaphragm. Pompe disease is one of the few myopathies, for which an established therapy is available. Thus, earlier detection of potential late-onset Pompe disease (LOPD) and earlier intervention would have a significant clinical impact. Our hypothesis is that sleep problems including sleep disordered breathing (SDB) and clinical symptoms may indicate an early stage of LOPD since decreased respiratory muscle activity generally first presents during sleep. Thus, the aims of this prospective, multicenter observational cohort study in Japan (PSSAP-J) are to demonstrate a higher prevalence of LOPD in a sleep lab-based population (primary outcome), and to identify predictive factors for LOPD from findings in diagnostic polysomnography (PSG) and clinical symptoms (secondary outcomes). The study design is a prospective multicenter observational cohort study. Consecutive patients who present to sleep labs due to suspected SDB for an overnight PSG will be enrolled. All patients will be measured for creatine kinase, GAA activity, and if necessary, genetic analysis of GAA. Furthermore, chest X-ray, pulmonary function test, and arterial blood gas analysis will be collected. Then, prevalence and specific findings of LOPD will be assessed. Congenital myopathy shows a shift from slow-deep to rapid-shallow breathing during transition from wakefulness to sleep accompanying a symptom of waking with gasping (actual further results are pending). The distribution in respiratory physiology between during wakefulness and sleep specific to LOPD may provide insights into early-stage detection. UMIN000039191, UMIN Clinical Trials Registry ( http://www.umin.ac.jp/ctr ).

Sections du résumé

BACKGROUND BACKGROUND
Pompe disease is an autosomal recessive disorder caused by deficiency of the acid α-glucosidase (GAA) enzyme. GAA deficiency induces progressive glycogen accumulation which leads to weakness of the respiratory muscle including the diaphragm. Pompe disease is one of the few myopathies, for which an established therapy is available. Thus, earlier detection of potential late-onset Pompe disease (LOPD) and earlier intervention would have a significant clinical impact.
PURPOSE OBJECTIVE
Our hypothesis is that sleep problems including sleep disordered breathing (SDB) and clinical symptoms may indicate an early stage of LOPD since decreased respiratory muscle activity generally first presents during sleep. Thus, the aims of this prospective, multicenter observational cohort study in Japan (PSSAP-J) are to demonstrate a higher prevalence of LOPD in a sleep lab-based population (primary outcome), and to identify predictive factors for LOPD from findings in diagnostic polysomnography (PSG) and clinical symptoms (secondary outcomes).
METHODS METHODS
The study design is a prospective multicenter observational cohort study. Consecutive patients who present to sleep labs due to suspected SDB for an overnight PSG will be enrolled. All patients will be measured for creatine kinase, GAA activity, and if necessary, genetic analysis of GAA. Furthermore, chest X-ray, pulmonary function test, and arterial blood gas analysis will be collected. Then, prevalence and specific findings of LOPD will be assessed.
RESULT RESULTS
Congenital myopathy shows a shift from slow-deep to rapid-shallow breathing during transition from wakefulness to sleep accompanying a symptom of waking with gasping (actual further results are pending).
DISCUSSION CONCLUSIONS
The distribution in respiratory physiology between during wakefulness and sleep specific to LOPD may provide insights into early-stage detection.
CLINICAL TRIAL REGISTRATION NUMBER BACKGROUND
UMIN000039191, UMIN Clinical Trials Registry ( http://www.umin.ac.jp/ctr ).

Identifiants

pubmed: 32808237
doi: 10.1007/s11325-020-02170-6
pii: 10.1007/s11325-020-02170-6
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

695-704

Subventions

Organisme : Investigator-Sponsored Study grant from Sanofi
ID : SGZ-2018-12403

Références

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Auteurs

Motoo Yamauchi (M)

Department of Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. motoo@naramed-u.ac.jp.

Hideaki Nakayama (H)

Department of Somnology, Tokyo Medical University, Tokyo, Japan.
Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan.

Satomi Shiota (S)

Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, Tokyo, Japan.

Yasuyoshi Ohshima (Y)

Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Jiro Terada (J)

Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Tsuguo Nishijima (T)

Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Morioka, Japan.

Motomichi Kosuga (M)

Division of Medical Genetics, National Center for Child Health and Development, Tokyo, Japan.

Takuro Kitamura (T)

Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health, Fukuoka, Japan.

Naoko Tachibana (N)

Center for Sleep-Related Disorders, Kansai Electric Power Hospital, Osaka, Japan.

Takuya Oguri (T)

Department of Neurology, Tosei General Hospital, Aichi, Japan.

Ryutaro Shirahama (R)

RESM Respiratory and Sleep Medical-Care Clinic, Yokohama, Japan.

Yasuhiro Aoki (Y)

Department of Respiratory Medicine, Prana Clinic, Saitama, Japan.

Keiko Ishigaki (K)

Department of Pediatrics, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.

Kazuma Sugie (K)

Department of Neurology, Nara Medical University, Nara, Japan.

Tomoko Yagi (T)

Ota General Hospital, Kanagawa, Japan.

Hisae Muraki (H)

Osaka Kaisei Hospital, Osaka, Japan.

Yukio Fujita (Y)

Department of Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Tsunenori Takatani (T)

Department of Anesthesiology, Nara Medical University, Nara, Japan.

Shigeo Muro (S)

Department of Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

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