From a systemic point of view, the following biomarkers have been used to assess the effectiveness of ERT and organ damage in FD: inter α-trypsin inhibitor heavy chain 4 (an anti-inflammatory protein), serum amyloid A1 (an acute-phase protein), enolase 1 (a tissue remodeling factor indicating the contribution of ischemic vascular pathology), and the enzyme endothelial nitric oxide synthase [57,58]. This evidence concerns the gene SAA1 and Fabry disease.