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Hereditary Spastic Paraplegia 28

Disease Details

Family Health Simplified

Description
Hereditary spastic paraplegia 28 (SPG28) is a neurodegenerative disorder characterized primarily by progressive weakness and stiffness (spasticity) in the muscles of the lower limbs.
Type
Hereditary spastic paraplegia 28 (SPG28) is typically inherited in an autosomal recessive manner.
Signs And Symptoms
Hereditary Spastic Paraplegia 28 (SPG28) is a type of hereditary spastic paraplegia. It is characterized by the following signs and symptoms:

- Progressive stiffness and spasticity (muscle tightness) in the lower limbs
- Muscle weakness, particularly in the legs
- Difficulty with walking, often leading to a more pronounced gait disturbance
- Some individuals may experience urinary urgency or incontinence
- In some cases, there may also be mild cognitive impairment or other neurological signs

These symptoms typically worsen over time, leading to increased difficulty with mobility.
Prognosis
Hereditary Spastic Paraplegia 28 (HSP 28) is a subtype of hereditary spastic paraplegia, a group of genetic disorders characterized by progressive weakness and spasticity (stiffness) of the legs. The prognosis can vary widely among individuals.

Generally, HSP 28 leads to a gradual worsening of symptoms over time. Most individuals with HSP 28 will experience increasing difficulty with walking and mobility, but the degree of impairment can differ significantly. Some may become wheelchair-dependent, while others maintain a degree of independent ambulation.

Life expectancy for individuals with HSP 28 is typically not reduced, but quality of life may be impacted due to mobility issues and potential complications such as falls or spasticity-related pain. Management is focused on symptomatic relief, physiotherapy, assistive devices, and sometimes medications to manage spasticity. Regular follow-up with a neurologist or specialist in genetic disorders is recommended to monitor progression and adjust treatment as needed.
Onset
Hereditary Spastic Paraplegia 28 (SPG28) typically presents with an onset in adulthood. The exact age of onset can vary, but symptoms usually appear in the third to fifth decades of life.
Prevalence
The prevalence of hereditary spastic paraplegia (HSP) type 28 is not well-defined due to its rarity. HSPs, in general, are a group of inherited disorders, and the specific prevalence can vary widely. However, HSP type 28 is considered very rare. If you need more precise numbers, specific genetic studies or registries might provide more detailed data.
Epidemiology
Hereditary Spastic Paraplegia 28 (SPG28) is a rare form of hereditary spastic paraplegia. Due to its rarity, specific epidemiological data is limited and not well-documented in the current medical literature. Generally, hereditary spastic paraplegias as a group have a prevalence of around 1-9 per 100,000 people, but precise figures for SPG28 are not available.
Intractability
Hereditary spastic paraplegia type 28 (HSP28) is generally considered intractable in the sense that there is currently no cure available. Treatment is typically focused on managing symptoms and improving quality of life through physical therapy, medications to manage spasticity, and assistive devices. Research is ongoing to better understand the disease and develop more effective treatments.
Disease Severity
Hereditary spastic paraplegia (HSP) 28, caused by mutations in the DDHD1 gene, typically manifests as a progressive neurological disorder. The severity can vary, but it generally leads to significant spasticity and weakness in the lower extremities.

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Healthcare Professionals
Disease Ontology ID - DOID:0110779
Pathophysiology
Hereditary spastic paraplegia 28 (HSP28) is a subtype of hereditary spastic paraplegia, a group of genetic disorders characterized by progressive weakness and spasticity of the lower extremities. The pathophysiology of HSP28 involves mutations in the DDHD1 gene, which encodes a phospholipase enzyme critical for lipid metabolism and maintaining membrane integrity. These mutations lead to dysfunctional or deficient enzyme activity, resulting in abnormal lipid accumulation in neurons. This disrupts axonal transport and causes axonal degeneration, particularly in the long corticospinal tracts, leading to the characteristic spasticity and weakness in the legs.
Carrier Status
Hereditary spastic paraplegia 28 (HSP28) is an autosomal dominant disorder. Carrier status typically isn't applicable because autosomal dominant disorders usually require only one copy of the mutated gene for the disease to manifest, and affected individuals typically display symptoms if they have the mutation. Therefore, individuals with one mutated gene copy are usually considered affected, rather than carriers.
Mechanism
Hereditary spastic paraplegia 28 (HSP28) is a subtype of hereditary spastic paraplegia (HSP), a group of genetic neurodegenerative disorders characterized primarily by progressive spasticity and weakness of the lower extremities.

**Mechanism:**
HSP28 is caused by mutations in the gene DDHD2, which encodes the enzyme phospholipase DDHD2. This enzyme is involved in the metabolism of phospholipids, which are essential components of cell membranes.

**Molecular Mechanisms:**
- **Phospholipase Activity:** DDHD2 plays a critical role in the hydrolysis of specific phospholipids, influencing lipid composition and homeostasis.
- **Lipid Droplet Regulation:** DDHD2 is implicated in the formation and regulation of lipid droplets within cells.
- **Axonal Transport and Maintenance:** Proper function of DDHD2 is essential for maintaining the integrity of axons, particularly in motor neurons. Disruption in phospholipid metabolism can impair axonal transport and maintenance, leading to the progressive neurological symptoms observed in HSP28.
- **Neuropathology:** Mutations in DDHD2 can disrupt its enzymatic function, leading to abnormal phospholipid accumulation and consequential neurodegeneration, primarily affecting the corticospinal tracts.

These molecular disruptions ultimately result in the progressive lower limb spasticity and weakness characteristic of HSP28.
Treatment
There is no cure for Hereditary Spastic Paraplegia 28 (HSP28), and treatment primarily focuses on managing symptoms and improving quality of life. Common treatment approaches include:

1. **Physical Therapy:** To maintain muscle strength, flexibility, and mobility.
2. **Medications:** To manage symptoms such as spasticity, pain, and bladder control issues. Common medications may include baclofen, tizanidine, or botulinum toxin injections.
3. **Assistive Devices:** Use of canes, walkers, or wheelchairs to aid with mobility.
4. **Occupational Therapy:** To assist with daily activities and improve functional abilities.

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Compassionate Use Treatment
Hereditary Spastic Paraplegia 28 (HSP28) is a rare genetic condition characterized by progressive muscle stiffness and weakness, primarily in the lower limbs.

1. **Compassionate Use Treatment**: Compassionate use, also known as expanded access, allows patients to gain access to investigational treatments outside of clinical trials. Eligibility and treatment options depend on the specific regulatory framework in each country.

2. **Off-label Treatments**: Off-label treatments may involve using existing medications in ways not specified in their official labeling. For HSP28, drugs aimed at alleviating spasticity and muscle stiffness, such as baclofen, tizanidine, or gabapentin, might be prescribed off-label.

3. **Experimental Treatments**: Investigational therapies currently being researched may include novel drug candidates, gene therapy approaches, or other advanced treatments. Participation in clinical trials may provide access to these experimental approaches.

Consultation with a healthcare provider specializing in genetic and neuromuscular disorders is essential for personalized treatment options.
Lifestyle Recommendations
Hereditary spastic paraplegia 28 (HSP 28) is a genetic disorder characterized by progressive weakness and stiffness of the leg muscles. Here are some lifestyle recommendations for managing the condition:

1. **Physical Therapy:** Regular physical therapy can help maintain muscle strength and flexibility, improving mobility and reducing stiffness.
2. **Exercise:** Low-impact exercises such as swimming, cycling, or using an elliptical machine can be beneficial. Exercise can help maintain cardiovascular health and muscle tone.
3. **Assistive Devices:** Utilization of canes, walkers, or braces may be necessary to assist with mobility and prevent falls.
4. **Occupational Therapy:** This can help in learning new ways to perform daily activities and maintain independence.
5. **Healthy Diet:** A balanced diet that supports overall health and well-being is recommended. Proper nutrition can help maintain muscle function and general health.
6. **Ergonomics:** Modifying the home and work environment to reduce strain and improve accessibility can enhance safety and comfort.
7. **Support Groups:** Connecting with support groups can provide emotional support and practical advice from others experiencing similar challenges.

Regular consultation with healthcare providers, including neurologists and physiatrists, is crucial for monitoring the condition and adjusting management plans as needed.
Medication
Hereditary Spastic Paraplegia 28 (HSP28) typically requires a comprehensive management approach rather than specific medications to halt or reverse the disease. However, symptom-specific treatments can be used to improve quality of life. These may include:

1. **Muscle Relaxants**: Baclofen, tizanidine, or diazepam to reduce spasticity.
2. **Physical Therapy**: Regular physical therapy to maintain muscle strength and flexibility.
3. **Antispasticity Medications**: Oral or injectable botulinum toxin might be an option.

There's no cure for HSP, so the focus is on managing symptoms and maintaining mobility. Always consult with a healthcare provider for a treatment plan tailored to the individual's needs.
Repurposable Drugs
For Hereditary Spastic Paraplegia 28 (HSP28), specific repurposable drugs are not well established. Research is ongoing to identify potential treatments. Some general approaches in HSP management can include symptomatic treatments such as baclofen, tizanidine, or botulinum toxin for spasticity, and other supportive therapies.
Metabolites
Hereditary Spastic Paraplegia 28 (SPG28) is a form of hereditary spastic paraplegia, a group of inherited disorders characterized by progressive weakness and spasticity of the legs. Unfortunately, specific metabolic changes or unique metabolites directly associated with SPG28 have not been well-documented or established in scientific literature to date. The primary focus in understanding SPG28 involves genetic analysis and the identification of mutations in related genes.
Nutraceuticals
Currently, there is no specific nutraceutical treatment for Hereditary Spastic Paraplegia 28 (HSP28). Managing HSP28 typically involves physical therapy, medications to manage symptoms such as spasticity, and supportive care. If new developments in nutraceuticals arise for HSP28, they should be discussed with a healthcare professional to ensure safety and efficacy.
Peptides
Hereditary spastic paraplegia 28 (HSP28) is a neurodegenerative disorder characterized primarily by progressive spasticity and weakness of the lower limbs. The condition is caused by mutations in the DDHD1 gene, which encodes a phospholipase enzyme involved in lipid metabolism.

As of now, there is no peptide treatment specifically approved for HSP28. Research is ongoing to explore various therapeutic options, including peptides and other molecular approaches, but no specific peptide-based treatment has been validated or widely adopted for this condition at this time.