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Jasinge E, Fernando M, Indika NLR, Trunzo R, Schröder S, Vidanapathirana DM, Jones PM, Jayasena S, Gunarathne AV, Ratnayake P. Urine Organic Analysis: Key Diagnostic Test for Fumaric Aciduria in a Sri Lankan Child. Lab Med 2021; 53:e48-e50. [PMID: 34643235 DOI: 10.1093/labmed/lmab083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Fumaric aciduria resulting from fumarate hydratase deficiency is a rare inherited disorder of the Krebs tricarboxylic acid cycle that is characterized by neurologic manifestations, a spectrum of brain abnormalities, and the excretion of fumaric acid in urine. We describe a 3 year old Sri Lankan boy who was referred at age 10 months with poor weight gain and hypotonia for further laboratory investigations. In addition to global developmental delay, there were noticeable dysmorphic features with a prominent forehead, low-set ears, micrognathia, and hypertelorism with persistent neutropenia. Urine organic acid assay revealed a massive elevation of fumaric acid on 2 occasions. Molecular analysis revealed a homozygous likely pathogenic missense variant, NM000143.3:c.1048C>T p. (Arg350Trp), in the FH gene, confirming the biochemical diagnosis. Our patient was the first patient in Sri Lanka molecularly diagnosed with fumaric aciduria. This case study highlights the importance of performing organic acid assays in children presenting with neurologic manifestations especially when these are suspected to have a metabolic basis.
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Affiliation(s)
- Eresha Jasinge
- Department of Chemical Pathology, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Mihika Fernando
- Department of Chemical Pathology, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Neluwa-Liyanage R Indika
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | | | | | - Patricia M Jones
- Department of Pathology, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, Texas, US
| | - Subashini Jayasena
- Department of Chemical Pathology, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | | | - Pyara Ratnayake
- Neurology Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
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2
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Peetsold M, Goorden S, Breuning M, Williams M, Bakker J, Jacobs E, Hussaarts-Odijk L, Peeters C. Fumarase Deficiency: A Case With a New Pathogenic Mutation and a Review of the Literature. J Child Neurol 2021; 36:310-323. [PMID: 33052056 DOI: 10.1177/0883073820962931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fumarase deficiency (FD) is a rare and severe autosomal disorder, caused by inactivity of the enzyme fumarase, due to biallelic mutations of the fumarase hydratase (FH) gene. Several pathogenic mutations have been published. The article describes an infant with failure to thrive, microcephaly, axial hypotonia, and developmental retardation with increased excretion of fumarate, no activity of fumarase and a homozygous mutation of the FH gene, which was until recently only known as a variant of unknown significance. Carriers of pathogenic mutations in the FH gene are at risk for developing renal cell carcinoma and should therefore be screened. Both parents were healthy carriers of the mutation and had decreased levels of enzyme activity. In addition, the article presents an overview and analysis of all cases of FD reported thus far in the literature.
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Affiliation(s)
- Marieke Peetsold
- Department of Pediatrics, 72471Alrijne Medical Center, Leiderdorp, the Netherlands
| | - Susan Goorden
- Laboratory Genetic Metabolic Disease, 26066Academic Medical Center, University of Amsterdam, the Netherlands
| | - Martijn Breuning
- Department of Clinical Genetics, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Monique Williams
- Department of Pediatrics, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Jaap Bakker
- Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, 6984Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Ed Jacobs
- Department of Clinical Chemistry and Laboratory Medicine, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Lydia Hussaarts-Odijk
- Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Center of Lysosomal and Metabolic disorders, 6984Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Cacha Peeters
- Department of Neurology, 4501Leiden University Medical Center, Leiden, the Netherlands
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3
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Expanding the genotype-phenotype correlation of childhood sensory polyneuropathy of genetic origin. Sci Rep 2020; 10:16184. [PMID: 32999401 PMCID: PMC7528082 DOI: 10.1038/s41598-020-73219-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/14/2020] [Indexed: 01/02/2023] Open
Abstract
Pure sensory polyneuropathy of genetic origin is rare in childhood and hence important to document the clinical and genetic etiologies from single or multi-center studies. This study focuses on a retrospective chart-review of neurological examinations and genetic and electrodiagnostic data of confirmed sensory polyneuropathy in subjects at a tertiary-care Children's Hospital from 2013 to 2019. Twenty subjects were identified and included. Neurological examination and electrodiagnostic testing showed gait-difficulties, absent tendon reflexes, decreased joint-position, positive Romberg's test and large fiber sensory polyneuropathy on sensory nerve conduction studies in all patients associated with lower-extremity spasticity (6), cardiac abnormalities or cardiomyopathy (5), developmental delay (4), scoliosis (3), epilepsy (3) and hearing-difficulties (2). Confirmation of genetic diagnosis in correlation with clinical presentation was obtained in all cases (COX20 n = 2, HADHA n = 2, POLG n = 1, FXN n = 4, ATXN2 n = 3, ATM n = 3, GAN n = 2, SPG7 n = 1, ZFYVE26 n = 1, FH n = 1). Our single-center study shows genetic sensory polyneuropathies associated with progressive neurodegenerative disorders such as mitochondrial ataxia, Friedreich ataxia, spinocerebellar ataxia type 2, ataxia telangiectasia, spastic paraplegia, giant axonal neuropathy, and fumarate hydratase deficiency. We also present our cohort data in light of clinical features reported for each gene-specific disease subtype in the literature and highlight the importance of genetic testing in the relevant clinical context of electrophysiological findings of peripheral sensory polyneuropathy.
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4
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Sciacovelli M, Schmidt C, Maher ER, Frezza C. Metabolic Drivers in Hereditary Cancer Syndromes. ANNUAL REVIEW OF CANCER BIOLOGY-SERIES 2020. [DOI: 10.1146/annurev-cancerbio-030419-033612] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cancer is a multifaceted disease in which inherited genetic variants can be important drivers of tumorigenesis. The discovery that germline mutations of metabolic genes predispose to familial forms of cancer caused a shift in our understanding of how metabolism contributes to tumorigenesis, providing evidence that metabolic alterations can be oncogenic. In this review, we focus on mitochondrial enzymes whose mutations predispose to familial cancer, and we fully appraise their involvement in cancer formation and progression. Elucidating the molecular mechanisms that orchestrate transformation in these diverse tumors may answer key biological questions about tumor formation and evolution, leading to the identification of new therapeutic targets of intervention.
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Affiliation(s)
- Marco Sciacovelli
- MRC (Medical Research Council) Cancer Unit, University of Cambridge, Cambridge CB2 0XZ, United Kingdom;,
| | - Christina Schmidt
- MRC (Medical Research Council) Cancer Unit, University of Cambridge, Cambridge CB2 0XZ, United Kingdom;,
| | - Eamonn R. Maher
- Department of Medical Genetics, NIHR (National Institute of Health Research) Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Christian Frezza
- MRC (Medical Research Council) Cancer Unit, University of Cambridge, Cambridge CB2 0XZ, United Kingdom;,
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5
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Ryder B, Moore F, Mitchell A, Thompson S, Christodoulou J, Balasubramaniam S. Fumarase Deficiency: A Safe and Potentially Disease Modifying Effect of High Fat/Low Carbohydrate Diet. JIMD Rep 2017; 40:77-83. [PMID: 29052812 DOI: 10.1007/8904_2017_65] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/24/2017] [Accepted: 10/04/2017] [Indexed: 11/25/2022] Open
Abstract
Fumarate hydratase deficiency (FHD) caused by biallelic alterations of the FH (fumarate hydratase) gene is a rare disorder of the tricarboxylic acid cycle, classically characterized by encephalopathy, profound psychomotor retardation, seizures, a spectrum of brain abnormalities and early death in childhood. Less common milder phenotypes with moderate cognitive impairment and long-term survival have been reported. In addition, heterozygous mutations of the FH gene are responsible for hereditary leiomyomatosis and renal cell cancer (HLRCC). There is currently no recommended disease modifying treatment for FHD and only isolated reports of unsuccessful dietary modifications. Herein, we describe the safe and possibly disease modifying effect of a high fat, low carbohydrate diet in a 14-year-old female with severe FHD.
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Affiliation(s)
- B Ryder
- Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - F Moore
- NSW Biochemical Genetics Service, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - A Mitchell
- Metabolic Dietetic Service, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - S Thompson
- Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Metabolic Dietetic Service, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - J Christodoulou
- Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Discipline of Genetic Medicine, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Discipline of Child & Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Neurodevelopmental Genomics Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - S Balasubramaniam
- Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW, Australia.
- Discipline of Genetic Medicine, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
- Discipline of Child & Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
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Baştuğ O, Kardaş F, Öztürk MA, Halis H, Memur Ş, Korkmaz L, Tağ Z, Güneş T. A rare cause of opistotonus; fumaric aciduria: The first case presentation in Turkey. Turk Arch Pediatr 2014; 49:74-6. [PMID: 26078636 DOI: 10.5152/tpa.2014.442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 06/17/2013] [Indexed: 11/22/2022]
Abstract
Fumaric aciduria is a rare autosomal recessive metabolic disease which is characterized with excessive fumaric acid exretion in urine. In the prenatal period, polyhydramniosis, intrauterine growth retardation, enlarged brain ventricles and brain anomalies are observed. Growth and development failure, hypotonia, seizures and brain atrophy are the common characteristics of patients with fumarase deficiency. On cranial imaging, the most common findings include polymicrogyria and ventriculomegaly. In our country where consanguineous marriages are common, the incidences of autosomal recessive diseases are expected to be high. In a patient who was born from a consanguineous marriage and referred to our hospital at the age of 45 days because of hyperamonemia and opistotonus, a diagnosis of fumaric aciduria was made with organic acid analysis performed considering metabolic diseases and this diagnosis was supported with radiological investigations. We thought this case was worth presenting, since there was no case of fumaric aciduria reported before in our country.
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Affiliation(s)
- Osman Baştuğ
- Department of Pediatrics, Division of Neanatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Fatih Kardaş
- Department of Pediatrics, Division of Nutrition and Metabolism, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mehmet Adnan Öztürk
- Department of Pediatrics, Division of Neanatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hülya Halis
- Department of Pediatrics, Division of Neanatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Şeyma Memur
- Department of Pediatrics, Division of Neanatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Levent Korkmaz
- Department of Pediatrics, Division of Neanatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Zuhal Tağ
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Tamer Güneş
- Department of Pediatrics, Division of Neanatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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7
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Haas NB, Nathanson KL. Hereditary kidney cancer syndromes. Adv Chronic Kidney Dis 2014; 21:81-90. [PMID: 24359990 DOI: 10.1053/j.ackd.2013.10.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/17/2013] [Accepted: 10/17/2013] [Indexed: 12/17/2022]
Abstract
Inherited susceptibility to kidney cancer is a fascinating and complex topic. Our knowledge about types of genetic syndromes associated with an increased risk of disease is continually expanding. Currently, there are 10 syndromes associated with an increased risk of all types of kidney cancer, which are reviewed herein. Clear cell kidney cancer is associated with von Hippel Lindau disease, chromosome 3 translocations, PTEN hamartomatous syndrome, and mutations in the BAP1 gene as well as several of the genes encoding the proteins comprising the succinate dehydrogenase complex (SDHB/C/D). Type 1 papillary kidney cancers arise in conjunction with germline mutations in MET and type 2 as part of hereditary leiomyomatosis and kidney cell cancer (fumarate hydratase [FH] mutations). Chromophone and oncocytic kidney cancers are predominantly associated with Birt-Hogg-Dubé syndrome. Patients with Tuberous Sclerosis Complex (TSC) commonly have angiomyolipomas and rarely their malignant counterpart epithelioid angiomyolipomas. The targeted therapeutic options for the kidney cancer associated with these diseases are just starting to expand and are an area of active clinical research.
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8
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Ezgu F, Krejci P, Wilcox WR. Mild clinical presentation and prolonged survival of a patient with fumarase deficiency due to the combination of a known and a novel mutation in FH gene. Gene 2013; 524:403-6. [DOI: 10.1016/j.gene.2013.03.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 03/07/2013] [Indexed: 11/30/2022]
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9
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Ottolenghi C, Hubert L, Allanore Y, Brassier A, Altuzarra C, Mellot-Draznieks C, Bekri S, Goldenberg A, Veyrieres S, Boddaert N, Barbier V, Valayannopoulos V, Slama A, Chrétien D, Ricquier D, Marret S, Frebourg T, Rabier D, Munnich A, de Keyzer Y, Toulhoat H, de Lonlay P. Clinical and biochemical heterogeneity associated with fumarase deficiency. Hum Mutat 2011; 32:1046-52. [PMID: 21560188 DOI: 10.1002/humu.21534] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 05/03/2011] [Indexed: 01/27/2023]
Abstract
Fumarase deficiency (FD), caused by biallelic alteration of the Fumarase Hydratase gene (FH), and a rare metabolic disorder that affects the Krebs cycle, causes severe neurological impairment and fumaric aciduria. Less than 30 unrelated cases are known to date. In addition, heterozygous mutations of the FH gene are responsible for hereditary leiomyomatosis and renal cell cancer (HLRCC). We report three additional patients with dramatically different clinical presentations of FD and novel missense mutations in the FH gene. One patient had severe neonatal encephalopathy, polymicrogyria, <1% enzyme activity, and mildly increased levels of urinary fumarate. The second patient had microcephaly, mental retardation, 20% of fumarase activity, and intermediate levels of urinary fumarate. The third patient had mild mental retardation, polymicrogyria, 42-61% enzyme activity in different cell types and massive amounts of urinary fumarate. In silico analysis predicted minor yet significant structural changes in the encoded proteins. The nuclear translocation of hypoxia-inducible factor (HIF)-1alpha (HIF1A) in cultured fibroblasts was similar to controls. These results extend the range of clinical and biochemical variation associated with FD, supporting the notion that patients with moderate increases in fumarate excretion should be investigated for this disease. The tumoral risk in the patients and their relatives requires adequate screening protocols.
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Affiliation(s)
- Chris Ottolenghi
- Service de Biochimie Métabolique, Hôpital Necker-Enfants Malades, Université Paris Descartes et Assistance Publique Hôpitaux de Paris, Paris, France
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10
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Picaud S, Kavanagh KL, Yue WW, Lee WH, Muller-Knapp S, Gileadi O, Sacchettini J, Oppermann U. Structural basis of fumarate hydratase deficiency. J Inherit Metab Dis 2011; 34:671-6. [PMID: 21445611 PMCID: PMC3109261 DOI: 10.1007/s10545-011-9294-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 01/27/2011] [Accepted: 01/31/2011] [Indexed: 01/08/2023]
Abstract
Fumarate hydratase catalyzes the stereospecific hydration across the olefinic double bond in fumarate leading to L-malate. The enzyme is expressed in mitochondrial and cytosolic compartments, and participates in the Krebs cycle in mitochondria, as well as in regulation of cytosolic fumarate levels. Fumarate hydratase deficiency is an autosomal recessive trait presenting as metabolic disorder with severe encephalopathy, seizures and poor neurological outcome. Heterozygous mutations are associated with a predisposition to cutaneous and uterine leiomyomas and to renal cancer. The crystal structure of human fumarate hydratase shows that mutations can be grouped into two distinct classes either affecting structural integrity of the core enzyme architecture, or are localized around the enzyme active site. An interactive version of this manuscript (which may contain additional mutations appended after acceptance of this manuscript) may be found on the SSIEM website at: http://www.ssiem.org/resources/structures/FH .
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Affiliation(s)
- Sarah Picaud
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Kathryn L. Kavanagh
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Wyatt W. Yue
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Wen Hwa Lee
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Susanne Muller-Knapp
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Opher Gileadi
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - James Sacchettini
- Department of Biochemistry & Biophysics, Texas A&M University, College Station, TX 77843-2128 USA
| | - Udo Oppermann
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
- Botnar Research Center, NIHR Oxford Biomedical Research Unit, Oxford, OX3 7LD UK
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11
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Lehtonen HJ. Hereditary leiomyomatosis and renal cell cancer: update on clinical and molecular characteristics. Fam Cancer 2011; 10:397-411. [PMID: 21404119 DOI: 10.1007/s10689-011-9428-z] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Heli J Lehtonen
- Department of Medical Genetics, Genome-Scale Biology Research Program, Biomedicum Helsinki, Haartman Institute, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, Helsinki 00290, Finland.
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12
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Allegri G, Fernandes MJ, Scalco FB, Correia P, Simoni RE, Llerena JC, de Oliveira MLC. Fumaric aciduria: an overview and the first Brazilian case report. J Inherit Metab Dis 2010; 33:411-9. [PMID: 20549362 DOI: 10.1007/s10545-010-9134-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 05/05/2010] [Accepted: 05/12/2010] [Indexed: 10/19/2022]
Abstract
Fumaric aciduria is a rare metabolic disease, with 40 cases reported so far. Fumarase deficiency leads mainly to brain abnormalities, developmental delay, and great accumulation of fumaric acid in urine. This work presents the first case of fumaric aciduria described in Brazil, which presented with some interesting clinical and biochemical findings such as colpocephaly, hepatic alterations, and marked metabolic acidosis since birth. Common findings were ventriculomegaly, hypotonia, and microcephaly. Biochemically, besides the high urinary fumaric acid excretion, atypical elevation of plasma citrulline, tyrosine and methionine levels were also observed. In order to show all features and variants of fumaric aciduria, literature data of 40 patients was reviewed and compared with the case reported here. Findings in all these patients demonstrate that this disorder does not yet have its phenotype completely defined; it is important that more patients be described.
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Affiliation(s)
- Gabriella Allegri
- Laboratório de Erros Inatos do Metabolismo, Departamento de Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Cidade Universitária, Ilha do Fundão, Centro de Tecnologia, bloco A, 536 C, 21941 900, Rio de Janeiro, Brasil.
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13
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Downregulation of SRF-FOS-JUNB pathway in fumarate hydratase deficiency and in uterine leiomyomas. Oncogene 2009; 28:1261-73. [PMID: 19151755 DOI: 10.1038/onc.2008.472] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Defects of metabolic enzymes result in a variety of manifestations not logically explained by the primary metabolic function. Dominant defects of fumarate hydratase (FH) result in predisposition to cutaneous and uterine leiomyomas, and renal cell cancer. FH is a metabolic enzyme of the tricarboxylic acid cycle, and its tumor-suppressor mechanism is not fully understood. We compared the consequences of FH deficiency and respiratory chain (RC) deficiency using global expression pattern of diploid primary fibroblasts. This approach utilized the information that RC defects do not seem to predispose to tumorigenesis, and the aim was to identify FH-specific signaling effects that might have relevance to tumor formation. These results were then compared to global expression patterns of FH-deficient and sporadic uterine leiomyoma data sets. We show here that FH-deficient fibroblasts share a common transcriptional fingerprint with FH-deficient and sporadic leiomyomas, highlighting the downregulation of serum response factor (SRF)-regulated transcripts, particularly the FOS-JUNB pathway. We confirmed the downregulation of this pathway at transcriptional and protein level. SRF has a fundamental function in the differentiation of smooth muscle progenitor cells, and its downregulation both in diploid FH-deficient primary fibroblasts and in leiomyomas suggests an early function in the mechanism of uterine leiomyoma formation in FH deficiency. Concordantly, the phosphorylated form of SRF, known to activate transcription, is undetectable in leiomyomas whereas clearly detected in several nuclei in the differentiated myometrium. A similar transcriptional SRF-pathway fingerprint in FH-deficient and sporadic leiomyomas emphasizes the potential importance of this pathway in primary events leading to leiomyomatosis.
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14
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Raimundo N, Ahtinen J, Fumić K, Barić I, Remes AM, Renkonen R, Lapatto R, Suomalainen A. Differential metabolic consequences of fumarate hydratase and respiratory chain defects. Biochim Biophys Acta Mol Basis Dis 2008; 1782:287-94. [DOI: 10.1016/j.bbadis.2008.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 01/22/2008] [Indexed: 12/28/2022]
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