Globotriaosylceramide accumulation in the Fabry kidney is ance was more limited than that observed in other cell types. cleared from multiple cell types after enzyme replacement therapy.No evidence of immune complex disease was found by immuno-Background. Fabry disease, a lysosomal storage disease caused fluorescence despite circulating anti-r-h␣GalA IgG antibodies. by deficient lysosomal ␣-galactosidase A activity, is character-Conclusions. These findings indicate a striking reversal of ized by globotriaosylceramide (GL-3) accumulation in multiple renal glycosphingolipid accumulation in the vasculature and in cell types, particularly the vasculature, leading to end organ other renal cell types, and suggest that long-term treatment failure. Accumulation in the kidney is responsible for progreswith r-h␣GalA may halt the progression of pathology and sive decline in renal function in male patients with the classical prevent renal failure in patients with Fabry disease. phenotype, resulting in renal failure in their third to fifth decades of life. With the advent of recombinant protein synthesis technology, enzyme replacement therapy has become a viable alternative to dialysis or renal transplantation, previously the Fabry disease is an X-linked recessive disorder in which only available treatment options for end-stage renal disease.affected males are deficient in the lysosomal enzyme Methods. The pre-and post-treatment renal biopsies were ␣-galactosidase A. This deficiency leads to accumulation analyzed from fifty-eight Fabry patients enrolled in a Phase 3 double-blind, randomized, placebo-controlled trial followed by