{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:08:37Z","timestamp":1780927717830,"version":"3.54.1"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012235","name":"Aeglea BioTherapeutics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012235","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JIMD Reports"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Arginase 1 deficiency (ARG1\u2010D) is a rare, progressive and debilitating urea cycle disorder characterized by clinical manifestations including spasticity, seizures, developmental delay, and intellectual disability. The aim of this systematic review was to identify and summarize the natural history of ARG1\u2010D and the unmet needs of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search of published case reports was undertaken to identify patients with ARG1\u2010D regardless of interventions, comparisons, or outcomes. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other evidence\u2010based medicine literature databases were searched on 20 April 2020. Quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. (PROSPERO registration: CRD42020212142.)<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and fifty seven ARG1\u2010D patients were included from 111 publications (good overall quality based on JBI's Checklist); 84 (53.5%) were males. Motor deficits (including spasticity), intellectual disability, and seizures were reported in &gt;50% of the cases. Mean age (SD) at diagnosis was 6.4\u2009years and the laboratory findings most commonly reported to support diagnosis included elevated plasma arginine (81.5%), mutation in<jats:italic>ARG1<\/jats:italic>gene through genetic testing (60%), and absence\/reduction of red blood cell arginase activity (51%). Reported management approaches mainly included dietary protein restriction (68%), nitrogen scavengers (45%), and essential amino acid supplements (21%). Author\u2010reported clinical improvement was documented for 26% of patients, 15% deteriorated, and 19% had limited or no change; notably, no indication of clinical outcome was reported for 40% cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This review illustrates a significant burden of disease and highlights a considerable unmet need for clinically effective treatment options for patients with ARG1\u2010D.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmd2.12283","type":"journal-article","created":{"date-parts":[[2022,3,26]],"date-time":"2022-03-26T00:38:57Z","timestamp":1648255137000},"page":"330-340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Natural history of arginase 1 deficiency and the unmet needs of patients: A systematic review of case reports"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6620-0716","authenticated-orcid":false,"given":"Aseel","family":"Bin Sawad","sequence":"first","affiliation":[{"name":"Aeglea BioTherapeutics, Inc. Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Pothukuchy","sequence":"additional","affiliation":[{"name":"Aeglea BioTherapeutics, Inc. Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Badeaux","sequence":"additional","affiliation":[{"name":"Aeglea BioTherapeutics, Inc. Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Hodson","sequence":"additional","affiliation":[{"name":"Aeglea BioTherapeutics, Inc. Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Bubb","sequence":"additional","affiliation":[{"name":"Aeglea BioTherapeutics, Inc. Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Lindsley","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research \u2010 Evidence Synthesis IQVIA, Inc. 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