Fabry disease FD is a lysosomal storage disorder of X-linked inheritance. We aimed at elucidating the link between skin cells and nociceptor sensitization contributing to FD pain in a sex-associated manner.
We used cultured keratinocytes and fibroblasts of 27 adult FD patients and 20 healthy controls. Epidermal keratinocytes and dermal fibroblasts were cultured and immunoreacted to evaluate Gb3 load. Gene expression analysis of pain-related ion channels and pro-inflammatory cytokines was performed in dermal fibroblasts.
We further investigated electrophysiological properties of induced pluripotent stem cell iPSC derived sensory-like neurons of a man with FD and a healthy man and incubated the cells with interleukin 8 IL-8 or fibroblast supernatant as an in vitro model system. Keratinocytes displayed no intracellular, but membrane-bound Gb3 deposits. Patch-clamp studies revealed reduced rheobase currents for both iPSC neuron cell lines incubated with IL-8 or fibroblast supernatant of women with FD.
This may result in cutaneous nociceptor sensitization as a potential mechanism contributing to a sex-associated FD pain phenotype. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: All relevant data are within the manuscript and its Supporting Information files.
The sponsors or funders did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Reduction or absence of GLA activity results in a multi-organ disease with limited life expectancy and lysosomal depositions of globotriaosylceramide Gb3 [ 2 ]. Although FD is X-linked, both sexes may reach all levels of disease severity. One of the earliest symptoms of FD is episodic acral burning pain [ 3 ] which is typically triggered by heat, inflammation or physical activity [ 4 ] and is mostly attributed to small nerve fiber impairment.
