Investigation of enzyme defects in children with lactic acidosis

Pharmacological biotin supplementation maintains biotin status and function in rats administered dietary carbamazepine

Biotin status and function are decreased during oral carbamazepine (CBZ) administration in both humans and rats, but it is not known whether biotin supplementation can prevent these decreases. To test the effectiveness of pharmacologic biotin supplementation during CBZ administration, 55 rats were randomly divided into 4 groups (0.06 mg biotin/kg diet +/- 3.75 g CBZ/kg diet and 6.0 mg biotin/kg diet +/- 3.75 g CBZ/kg diet). CBZ and biotin-supplemented diets began on d 5 and 26, respectively, and continued through d 68. Rats (n = 5/group) were killed on d 5, 26, 47 or 68. CBZ reduced serum and liver free biotin (P < 0.05), whereas biotin supplementation during CBZ administration maintained biotin status. CBZ also decreased specific activities and abundance of biotinylated pyruvate and acetyl CoA carboxylases (PC and ACC, P < 0.05) in brain and liver, whereas biotin supplementation prevented these decreases for ACC. Specific activity of PC was maintained upon biotin supplementation, but the abundance of biotinylated PC remained significantly decreased. Brain and serum lactate were elevated after 68 d of CBZ treatment and were reduced to control lactate concentrations upon biotin supplementation (P < 0.05). Conversion of lactate to pyruvate and simultaneous generation of NADH during biotin supplementation could explain how increases in PC activity occur without changes in the abundance of biotinylated PC because we found NADH to be an activator of PC activity in vitro. These results support the use of biotin supplementation as a concurrent strategy during CBZ administration to help maintain biotin status, function of biotin-dependent enzymes and decrease CBZ-induced lactate accumulation.

Dietary carbamazepine administration decreases liver pyruvate carboxylase activity and biotinylation by decreasing protein and mRNA expression in rats

Clinical data demonstrate that certain antiepileptic drugs including carbamazepine (CBZ) decrease serum biotin concentration 45-50% and increase urine and serum organic acids, which is suggestive of reduced function of biotin-dependent enzymes. However, little is known about biotin-dependent enzyme function at the tissue level in patients undergoing long-term CBZ treatment. We recently established that dietary CBZ administration to rats increases brain lactate and also decreases specific enzymatic activity and the relative abundance of hepatic biotinylated pyruvate carboxylase (PC). To examine the mechanism of altered activity and abundance of biotinylated PC, the effect of orally administered CBZ on hepatic PC protein and mRNA expression was examined in rats consuming a physiologically relevant level of dietary biotin (0.06 mg/kg). Rats were fed 0 or 3.4 g CBZ/kg diet for 28 d, a dose designed to achieve clinically relevant serum CBZ concentrations. Hepatic biotinylated PC and PC activity were significantly reduced by approximately 43 and 30%, respectively, in the drug-treated group. Liver PC protein expression and mRNA were approximately 43 and 35% lower, respectively, in the drug-treated group than in controls. Brain biotinylated PC was significantly lower (29%), whereas specific enzymatic activity was 175% higher in rats consuming the 3.4 g CBZ/kg diet. Brain, but not serum, lactate was significantly higher in rats consuming CBZ. Taken together, the lower PC protein and mRNA expression provide a plausible biochemical mechanism to explain the decreased abundance of biotinylated hepatic PC observed in previous studies.

2,3,7,8-Tetrachlorodibenzo-p-dioxin induced alterations of pyruvate carboxylase levels and lactate dehydrogenase isozyme shifts in C57BL/6J male mice

A dose-dependent reduction of hepatic pyruvate carboxylase levels and activity occurs in C57BL/6J male mice given 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) i.p. in a corn oil carrier. The dose range was from 1 to 75 micrograms/kg body weight and the analysis was done 8 days postinjection. At the maximum TCDD level investigated, we found a 10-fold reduction in pyruvate carboxylase activity. Furthermore, TCDD at a dose of 1 microgram/kg body weight blocks corn oil induction of an increase in the amount of pyruvate carboxylase in liver protein extracts. At doses beyond those required to initiate a reduction in pyruvate carboxylase, lactate dehydrogenase isozyme patterns shift. This is accompanied by an increase in blood lactic acid levels. We propose that TCDD-mediated reduction in pyruvate carboxylase and lactate dehydrogenase isozyme shifts may represent a major component in TCDD toxicity.