Emerging roles of autophagy in hepatic tumorigenesis and therapeutic strategies in glycogen storage disease type Ia: A review.

Glycogen storage disease type Ia (GSD‐Ia) is an inherited metabolic disease caused by a deficiency in glucose‐6‐phosphatase‐α (G6Pase‐α or G6PC) which plays a critical role in blood glucose homeostasis by catalyzing the hydrolysis of glucose‐6‐phosphate (G6P) to glucose and phosphate in the terminal step of glycogenolysis and gluconeogenesis. Patients with GSD‐Ia manifest life‐threatening fasting hypoglycemia along with the excessive accumulation of hepatic glycogen and triglycerides which results in hepatomegaly and a risk of long‐term complications such as hepatocellular adenoma and carcinoma (HCA/HCC). The etiology of HCA/HCC development in GSD‐Ia, however, is unknown. Recent studies have shown that the livers in model animals of GSD‐Ia display impairment of autophagy, a cellular recycling process which is critical for energy metabolism and cellular homeostasis. However, molecular mechanisms of autophagy impairment and its involvement in pathogenesis in GSD‐Ia are still under investigation. Here, we summarize the latest advances for signaling pathways implicated in hepatic autophagy impairment and the roles of autophagy in hepatic tumorigenesis in GSD‐Ia. In addition, recent evidence has illustrated that autophagy plays an important role in hepatic metabolism and liver‐directed gene therapy mediated by recombinant adeno‐associated virus (rAAV). Therefore, we highlight the possible role of hepatic autophagy in metabolic control and rAAV‐mediated gene therapy for GSD‐Ia. In this review, we also provide potential therapeutic strategies for GSD‐Ia on the basis of molecular mechanisms underlying hepatic autophagy impairment in GSD‐Ia. [ABSTRACT FROM AUTHOR]