In mucopolysaccharidosis-I (MPS-I
IntroductionHurler syndrome (mucopolysaccharidosis [MPS] type I) is an inborn error of glycosaminoglycan (GAG) metabolism caused by deficiency of ␣-L-iduronidase required for heparan sulfate (HS) and dermatan sulfate (DS) degradation. 1-3 HS and DS accumulation leads to cell and organ dysfunction. While progressive neuropsychologic dysfunction is a hallmark of Hurler and related storage diseases, 4 its cellular and molecular mechanisms remain undefined.The fibroblast growth factor (FGF) cytokine family affects cell growth, migration, differentiation, and neuroectodermal development. 5 FGF-2, a prototypical member involved in tissue morphogenesis and neurogenesis, 6 has 2 kinds of cell-surface receptors. Specific, high-affinity FGF receptors (FGFRs) possessing intrinsic tyrosine kinase activity mediate cellular responses, while lowaffinity receptors composed of HS proteoglycans (HSPGs) act as extracellular FGF-2 reservoirs and coreceptors. 7 Although its mechanism of formation is unclear, the FGF-2-FGFR-HSPG complex is necessary for mitogenesis and optimal biologic response to FGF-2. 8,9 Cell-type-specific and developmentally regulated HSPG synthesis regulates cell growth and differentiation by modulating extracellular signaling molecule activity. [10][11][12] Specificity of interactions between HSPG and signaling molecules depends on HSPG sequence, location, and 3-dimensional structure. 11,13 The importance of HSPG in FGF signaling is underscored by their role in neurogenesis, axonal guidance, and synapse formation. 12,14 FGF-2 also protects neurons against apoptosis and promotes neuronal survival. 15 While GAGs synthesized by cultured Hurler fibroblasts are thought to be structurally normal, 16 GAGs that accumulate in a tissue-specific manner 17 consist of a combination of large, normally sized GAGs and partially degraded, smaller chains (oligosaccharides). 18,19 How accumulated oligosaccharides cause abnormal tissue development and function remains uncertain. Our previous studies on normal hematopoiesis suggest that a high concentration of small, abnormally sulfated HS chains (such as may be present in Hurler syndrome) are detrimental to orderly stem-cell growth and Supported by the U.S. Department of Veterans Affairs (P.G.), NIH 1-R03-HD-41 411-01 and NIH 1-R01-NS-48 606-01 (P.G.), the Children's Cancer Research Fund (P.G., C.P.), and the University of Minnesota Medical School.C. Pan and S.E.S. designed and performed research, analyzed data, and wrote the manuscript; M.S.N., J.J.B., and E.J.S. performed research and analyzed data; M.R. and L.K. isolated and cultured multipotent progenitor cells; R.Z. and S.B.S. designed research; C. Peters provided bone marrow samples and designed research; P.G. designed research, analyzed data, and wrote the manuscript. For personal use only. on May 9, 2018. by guest www.bloodjournal.org From differentiation. [20][21][22] We hypothesize that abnormal size and sulfation of accumulated HS oligosaccharides leads to aberrant functional properti...