Evidence map›Paper›PMID 40430081›Full record

ArticleInternational journal of molecular sciences2025

Identification of Surrogate Biomarkers for Mucopolysaccharidosis Type IVA.

Yasuhiko Ago, Shaukat Khan, Kimberly Klipner, Allison Bradford, Shunji Tomatsu

Abstract read
In one paragraph

Article in International journal of molecular sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Natural History of Morquio A Syndrome.Journal of inherited metabolic disease · 2026
    Review
  3. Recent advances in mucopolysaccharidosis IVA treatment.Orphanet journal of rare diseases · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yasuhiko AgoNemours Children's Health, Wilmington, DE 19803, USA.ORCID 0000-0001-5307-3658
Shaukat KhanNemours Children's Health, Wilmington, DE 19803, USA.
Kimberly KlipnerNemours Children's Health, Wilmington, DE 19803, USA.
Allison BradfordNemours Children's Health, Wilmington, DE 19803, USA.ORCID 0009-0009-3586-8807
Shunji TomatsuNemours Children's Health, Wilmington, DE 19803, USA.ORCID 0000-0002-0673-2160

Funding

NIH HHS 1R01HD102545-01A1
6 · The paper itself

Abstract

Mucopolysaccharidosis type IVA (MPS IVA, Morquio A syndrome) is a rare inherited disorder characterized by skeletal dysplasia due to deficient N-acetylgalactosamine-6-sulfate sulfatase activity, resulting in glycosaminoglycan (GAG) accumulation. Identifying accurate biomarkers reflecting clinical severity and therapeutic response remains challenging. This study evaluated potential surrogate biomarkers, including N-terminal pro-C-type natriuretic peptide (NT-proCNP), collagen types I and II, mono-sulfated keratan sulfate (KS), di-sulfated KS, and chondroitin-6-sulfate (C6S), in blood and urine samples from 60 patients ranging from 1 to 62 years of age. NT-proCNP levels were significantly elevated in patients of all ages and negatively correlated with growth impairment, especially after 8 years of age. Collagen type I levels significantly increased in adult patients, whereas collagen type II showed age-dependent elevations. Urinary KS, in mono- and di-sulfated forms, demonstrated moderate negative correlations with growth impairment. Moreover, NT-proCNP, mono- and di-sulfated KS in plasma, and urinary di-sulfated KS were not affected by enzyme replacement therapy in patients younger than 12 years, unlike urinary mono-sulfated KS. In conclusion, NT-proCNP has emerged as a promising independent biomarker reflecting the severity of skeletal dysplasia and possibly the near-future growth rate. These findings highlight the potential role of NT-proCNP in clinical assessment and monitoring therapeutic efficacy, addressing current unmet needs in MPS IVA management.

Indexed as

BiomarkersMucopolysaccharidosis IVAdolescentAdultChildChild, PreschoolChondroitinsulfatasesChondroitin SulfatesCollagen Type ICollagen Type IIEnzyme Replacement TherapyFemaleGlycosaminoglycansHumansInfantKeratan SulfateBiomarkersChondroitinsulfatasesChondroitin SulfatesCollagen Type ICollagen Type IIGlycosaminoglycansKeratan SulfateNatriuretic Peptide, C-TypePeptide Fragmentsbiomarkersenzyme replacement therapykeratan sulfatemucopolysaccharidosis IVANT-proCNPskeletal dysplasia

Identifiers

PMID40430081
PMCPMC12112068

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.