Hydrolysis of glucosylceramide (GlcCer) by glucocerebrosidase (GCase) in the lysosome (A). GCase is activated by saposin C. In lysosomal storage diseases, an enzyme deficiency is responsible for the accumulation of its substrate in the cell lysosome (overload disease). Gaucher disease is caused by a deficiency in glucocerebrosidase (GCase) (or β-glucosidase), which leads to an accumulation of GlcCer. GlcCer forms fibrillar aggregates that accumulate in macrophages and result in the cell cytoplasm presenting a characteristic “crumpled tissue paper” appearance (B), personal pictures, with the courtesy of Fabrice Camou and Rachid Seddik). These cells, known as Gaucher cells, infiltrate various organs (e.g., bone marrow, spleen, and liver) and are responsible for the major signs of the disease.