2
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Paquay S, Bourillon A, Pichard S, Benoist JF, de Lonlay P, Dobbelaere D, Fouilhoux A, Guffon N, Rouvet I, Labarthe F, Mention K, Touati G, Valayannopoulos V, Ogier de Baulny H, Elmaleh-Bergès M, Acquaviva-Bourdain C, Vianey-Saban C, Schiff M. Mitochondrial acetoacetyl-CoA thiolase deficiency: basal ganglia impairment may occur independently of ketoacidosis. J Inherit Metab Dis 2017; 40:415-422. [PMID: 28255778 DOI: 10.1007/s10545-017-0021-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Mitochondrial acetoacetyl-CoA thiolase (T2) deficiency affects ketone body and isoleucine catabolism. Neurological impairment may occur secondary to ketoacidotic episodes. However, we observed neuromotor abnormalities without ketoacidotic events in two T2-deficient families. We hypothesized that the neurological signs were related to the genetic defect and may occur independently of ketoacidotic episodes. We therefore conducted a retrospective review on a French T2-deficient patient series searching for neuromotor impairment. METHODS In total, 26 cases were retrospectively analysed for clinical, biological and neuroimaging data. RESULTS Neurological findings were observed for 6/26 (23%) patients. Among these, two had never experienced ketoacidotic episodes, though they developed extrapyramidal signs with putamen involvement. Two of the other four patients developed neurological abnormalities before the first ketoacidotic crisis, with putamen involvement in one case. The third patient developed extrapyramidal symptoms more than 10 years after the initial decompensation with globus pallidus involvement. The last patient developed extrapyramidal signs immediately after a severe ketoacidotic crisis with putaminal lesions. CONCLUSIONS Most T2-deficient patients achieved normal neurodevelopment. However, on account of the role of T2 in isoleucine catabolism, these patients are potentially exposed to accumulation of toxic isoleucine-derived metabolites, which may contribute to neurological impairment. Our findings confirm previous observations that neurological symptoms in T2 deficiency may occur unrelated to ketoacidosis. The role of protein restriction as a preventive measure against neurological symptoms could not be established in this study and deserves further evaluation. Long-term follow-up data on children diagnosed by newborn screening may clarify the pathogenesis of this neurometabolic association.
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Affiliation(s)
- Stéphanie Paquay
- Reference Center for Inborn Errors of Metabolism, Robert Debré University Hospital, 48 Bd Sérurier, Paris, F-75935 Cedex 19, France
- Pediatric Neurology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Samia Pichard
- Reference Center for Inborn Errors of Metabolism, Robert Debré University Hospital, 48 Bd Sérurier, Paris, F-75935 Cedex 19, France
| | | | - Pascale de Lonlay
- Reference Center for Inborn Errors of Metabolism, Hôpital Necker, APHP, Paris, France
- Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
| | - Dries Dobbelaere
- Reference Center for Inherited Metabolic Diseases in Child and Adulthood, University Children's Hospital Jeanne de Flandre, Lille, France
| | - Alain Fouilhoux
- Reference Center for Inherited Metabolic Diseases, Hôpital Femme-Mère-Enfant, CHU Lyon, Lyon, France
| | - Nathalie Guffon
- Reference Center for Inherited Metabolic Diseases, Hôpital Femme-Mère-Enfant, CHU Lyon, Lyon, France
| | - Isabelle Rouvet
- Centre de Biotechnologie Cellulaire et Biothèque, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, CHU Lyon, Lyon, France
| | | | - Karine Mention
- Reference Center for Inherited Metabolic Diseases in Child and Adulthood, University Children's Hospital Jeanne de Flandre, Lille, France
| | - Guy Touati
- Department of Pediatrics, CHU Toulouse, Toulouse, France
| | - Vassili Valayannopoulos
- Reference Center for Inborn Errors of Metabolism, Hôpital Necker, APHP, Paris, France
- Sanofi-Genzyme, Cambridge, MA, USA
| | - Hélène Ogier de Baulny
- Reference Center for Inborn Errors of Metabolism, Robert Debré University Hospital, 48 Bd Sérurier, Paris, F-75935 Cedex 19, France
| | | | - Cécile Acquaviva-Bourdain
- Service Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, CHU Lyon, Lyon, France
| | - Christine Vianey-Saban
- Service Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, CHU Lyon, Lyon, France
| | - Manuel Schiff
- Reference Center for Inborn Errors of Metabolism, Robert Debré University Hospital, 48 Bd Sérurier, Paris, F-75935 Cedex 19, France.
- UMR1141, PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
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5
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Gallardo ME, Desviat LR, Rodríguez JM, Esparza-Gordillo J, Pérez-Cerdá C, Pérez B, Rodríguez-Pombo P, Criado O, Sanz R, Morton DH, Gibson KM, Le TP, Ribes A, de Córdoba SR, Ugarte M, Peñalva MÁ. The molecular basis of 3-methylcrotonylglycinuria, a disorder of leucine catabolism. Am J Hum Genet 2001; 68:334-46. [PMID: 11170888 PMCID: PMC1235267 DOI: 10.1086/318202] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2000] [Accepted: 12/12/2000] [Indexed: 11/03/2022] Open
Abstract
3-Methylcrotonylglycinuria is an inborn error of leucine catabolism and has a recessive pattern of inheritance that results from the deficiency of 3-methylcrotonyl-CoA carboxylase (MCC). The introduction of tandem mass spectrometry in newborn screening has revealed an unexpectedly high incidence of this disorder, which, in certain areas, appears to be the most frequent organic aciduria. MCC, an heteromeric enzyme consisting of alpha (biotin-containing) and beta subunits, is the only one of the four biotin-dependent carboxylases known in humans that has genes that have not yet been characterized, precluding molecular studies of this disease. Here we report the characterization, at the genomic level and at the cDNA level, of both the MCCA gene and the MCCB gene, encoding the MCC alpha and MCC beta subunits, respectively. The 19-exon MCCA gene maps to 3q25-27 and encodes a 725-residue protein with a biotin attachment site; the 17-exon MCCB gene maps to 5q12-q13 and encodes a 563-residue polypeptide. We show that disease-causing mutations can be classified into two complementation groups, denoted "CGA" and "CGB." We detected two MCCA missense mutations in CGA patients, one of which leads to absence of biotinylated MCC alpha. Two MCCB missense mutations and one splicing defect mutation leading to early MCC beta truncation were found in CGB patients. A fourth MCCB mutation also leading to early MCC beta truncation was found in two nonclassified patients. A fungal model carrying an mccA null allele has been constructed and was used to demonstrate, in vivo, the involvement of MCC in leucine catabolism. These results establish that 3-methylcrotonylglycinuria results from loss-of-function mutations in the genes encoding the alpha and beta subunits of MCC and complete the genetic characterization of the four human biotin-dependent carboxylases.
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MESH Headings
- Adult
- Amino Acid Metabolism, Inborn Errors/enzymology
- Amino Acid Metabolism, Inborn Errors/genetics
- Amino Acid Metabolism, Inborn Errors/pathology
- Amino Acid Sequence
- Aspergillus nidulans/drug effects
- Aspergillus nidulans/genetics
- Aspergillus nidulans/growth & development
- Base Sequence
- Blotting, Northern
- Carbon-Carbon Ligases/genetics
- Carbon-Carbon Ligases/metabolism
- Child, Preschool
- Chromosome Mapping
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 5/genetics
- DNA/chemistry
- DNA/genetics
- DNA Mutational Analysis
- DNA, Complementary/chemistry
- DNA, Complementary/genetics
- Exons
- Female
- Gene Expression Regulation, Enzymologic
- Genes/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Infant
- Introns
- Isoenzymes/genetics
- Isoenzymes/metabolism
- Leucine/metabolism
- Leucine/pharmacology
- Molecular Sequence Data
- Mutation
- Protein Subunits
- RNA/genetics
- RNA/metabolism
- Radiation Hybrid Mapping
- Sequence Analysis, DNA
- Tissue Distribution
- Transcription, Genetic
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Affiliation(s)
- M. Esther Gallardo
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Lourdes R. Desviat
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - José M. Rodríguez
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Jorge Esparza-Gordillo
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Celia Pérez-Cerdá
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Belén Pérez
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Pilar Rodríguez-Pombo
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Olga Criado
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Raul Sanz
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - D. Holmes Morton
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - K. Michael Gibson
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Thuy P. Le
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Antonia Ribes
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Santiago Rodríguez de Córdoba
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Magdalena Ugarte
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
| | - Miguel Á. Peñalva
- Centro de Investigaciones Biológicas CSIC, Fundación Jiménez Díaz, and Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid, Madrid; Clinic for Special Children, Strasburg, PA; Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla; and Institut de Bioquímica Clìnica, Corporació Sanitària Clínic, Barcelona
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