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Deleanu C, Nicolescu A. NMR Spectroscopy in Diagnosis and Monitoring of Methylmalonic and Propionic Acidemias. Biomolecules 2024; 14:528. [PMID: 38785935 PMCID: PMC11117674 DOI: 10.3390/biom14050528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/21/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Although both localized nuclear magnetic resonance spectroscopy (MRS) and non-localized nuclear magnetic resonance spectroscopy (NMR) generate the same information, i.e., spectra generated by various groups from the structure of metabolites, they are rarely employed in the same study or by the same research group. As our review reveals, these techniques have never been applied in the same study of methylmalonic acidemia (MMA), propionic acidemia (PA) or vitamin B12 deficiency patients. On the other hand, MRS and NMR provide complementary information which is very valuable in the assessment of the severity of disease and efficiency of its treatment. Thus, MRS provides intracellular metabolic information from localized regions of the brain, while NMR provides extracellular metabolic information from biological fluids like urine, blood or cerebrospinal fluid. This paper presents an up-to-date review of the NMR and MRS studies reported to date for methylmalonic and propionic acidemias. Vitamin B12 deficiency, although in most of its cases not inherited, shares similarities in its metabolic effects with MMA and it is also covered in this review.
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Affiliation(s)
- Calin Deleanu
- “Costin D. Nenitescu” Institute of Organic and Supramolecular Chemistry, Spl. Independentei 202-B, RO-060023 Bucharest, Romania
- “Petru Poni” Institute of Macromolecular Chemistry, Aleea Grigore Ghica Voda 41-A, RO-700487 Iasi, Romania
| | - Alina Nicolescu
- “Costin D. Nenitescu” Institute of Organic and Supramolecular Chemistry, Spl. Independentei 202-B, RO-060023 Bucharest, Romania
- “Petru Poni” Institute of Macromolecular Chemistry, Aleea Grigore Ghica Voda 41-A, RO-700487 Iasi, Romania
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Pulido N, Guevara-Morales JM, Rodriguez-López A, Pulido Á, Díaz J, Edrada-Ebel RA, Echeverri-Peña OY. 1H-Nuclear Magnetic Resonance Analysis of Urine as Diagnostic Tool for Organic Acidemias and Aminoacidopathies. Metabolites 2021; 11:891. [PMID: 34940649 PMCID: PMC8704601 DOI: 10.3390/metabo11120891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/03/2022] Open
Abstract
The utility of low-resolution 1H-NMR analysis for the identification of biomarkers provided evidence for rapid biochemical diagnoses of organic acidemia and aminoacidopathy. 1H-NMR, with a sensitivity expected for a field strength of 400 MHz at 64 scans was used to establish the metabolomic urine sample profiles of an infant population diagnosed with small molecule Inborn Errors of Metabolism (smIEM) compared to unaffected individuals. A qualitative differentiation of the 1H-NMR spectral profiles of urine samples obtained from individuals affected by different organic acidemias and aminoacidopathies was achieved in combination with GC-MS. The smIEM disorders investigated in this study included phenylalanine metabolism; isovaleric, propionic, 3-methylglutaconicm and glutaric type I acidemia; and deficiencies in medium chain acyl-coenzyme and holocarboxylase synthase. The observed metabolites were comparable and similar to those reported in the literature, as well as to those detected with higher-resolution NMR. In this study, diagnostic marker metabolites were identified for the smIEM disorders. In some cases, changes in metabolite profiles differentiated post-treatments and follow-ups while allowing for the establishment of different clinical states of a biochemical disorder. In addition, for the first time, a 1H-NMR-based biomarker profile was established for holocarboxylase synthase deficiency spectrum.
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Affiliation(s)
- Ninna Pulido
- San Ignacio University Hospital, Bogota 4665684, Colombia;
- Institute for the Study of Inborn Errors of Metabolism, School of Sciences, Pontificia Universidad Javeriana, Cra 7 # 43-82, Edificio 54 Lab 303A, Bogota 4665684, Colombia;
| | - Johana M. Guevara-Morales
- Institute for the Study of Inborn Errors of Metabolism, School of Sciences, Pontificia Universidad Javeriana, Cra 7 # 43-82, Edificio 54 Lab 303A, Bogota 4665684, Colombia;
| | - Alexander Rodriguez-López
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogota 4665684, Colombia;
- Chemistry Department, School of Sciences, Pontificia Universidad Javeriana, Bogota 4665684, Colombia;
| | - Álvaro Pulido
- Electrical and Electronics Department, Universidad Nacional de Colombia, Bogota 4665684, Colombia;
| | - Jhon Díaz
- Chemistry Department, School of Sciences, Pontificia Universidad Javeriana, Bogota 4665684, Colombia;
| | - Ru Angelie Edrada-Ebel
- The Natural Products Metabolomics Group, Strathclyde Institute of Pharmacy and Biomedical Sciences, Faculty of Science, University of Strathclyde, The John Arbuthnott Building, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Olga Y. Echeverri-Peña
- Institute for the Study of Inborn Errors of Metabolism, School of Sciences, Pontificia Universidad Javeriana, Cra 7 # 43-82, Edificio 54 Lab 303A, Bogota 4665684, Colombia;
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Nicolescu A, Blanita D, Boiciuc C, Hlistun V, Cristea M, Rotaru D, Pinzari L, Oglinda A, Stamati A, Tarcomnicu I, Tutulan-Cunita A, Stambouli D, Gladun S, Revenco N, Uşurelu N, Deleanu C. Monitoring Methylmalonic Aciduria by NMR Urinomics. Molecules 2020; 25:molecules25225312. [PMID: 33202577 PMCID: PMC7697698 DOI: 10.3390/molecules25225312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 12/19/2022] Open
Abstract
The paper reports on monitoring methylmalonic aciduria (MMA)-specific and non-specific metabolites via NMR urinomics. Five patients have been monitored over periods of time; things involved were diet, medication and occasional episodes of failing to comply with prescribed diets. An extended dataset of targeted metabolites is presented, and correlations with the type of MMA are underlined. A survey of previous NMR studies on MMA is also presented.
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Affiliation(s)
- Alina Nicolescu
- “Petru Poni” Institute of Macromolecular Chemistry, Romanian Academy, Aleea Grigore Ghica Voda 41A, RO-700487 Iasi, Romania;
- “C. D. Nenitescu” Centre of Organic Chemistry, Romanian Academy, Spl. Independentei 202B, RO-060023 Bucharest, Romania
- Correspondence: (A.N.); (N.U.); or (C.D.); Tel.: +40-744-340-456 (C.D.)
| | - Daniela Blanita
- Institute of Mother and Child, Str. Burebista 93, MD-2062 Chisinau, Moldova; (D.B.); (C.B.); (V.H.); (L.P.); (S.G.)
| | - Chiril Boiciuc
- Institute of Mother and Child, Str. Burebista 93, MD-2062 Chisinau, Moldova; (D.B.); (C.B.); (V.H.); (L.P.); (S.G.)
| | - Victoria Hlistun
- Institute of Mother and Child, Str. Burebista 93, MD-2062 Chisinau, Moldova; (D.B.); (C.B.); (V.H.); (L.P.); (S.G.)
| | - Mihaela Cristea
- “Petru Poni” Institute of Macromolecular Chemistry, Romanian Academy, Aleea Grigore Ghica Voda 41A, RO-700487 Iasi, Romania;
| | - Dorina Rotaru
- “Gheorghe Palade” City Clinical Hospital, Str. Melestiu 20, MD-2001 Chisinau, Moldova;
| | - Ludmila Pinzari
- Institute of Mother and Child, Str. Burebista 93, MD-2062 Chisinau, Moldova; (D.B.); (C.B.); (V.H.); (L.P.); (S.G.)
| | - Ana Oglinda
- “Nicolae Testemitanu” State University of Medicine and Pharmacy, Bd. Stefan cel Mare si Sfint 165, MD-2004 Chisinau, Moldova; (A.O.); (A.S.); (N.R.)
| | - Adela Stamati
- “Nicolae Testemitanu” State University of Medicine and Pharmacy, Bd. Stefan cel Mare si Sfint 165, MD-2004 Chisinau, Moldova; (A.O.); (A.S.); (N.R.)
| | - Isabela Tarcomnicu
- Cytogenomic Medical Laboratory, Calea Floreasca 35, RO-014453 Bucharest, Romania; (I.T.); (A.T.-C.); (D.S.)
| | - Andreea Tutulan-Cunita
- Cytogenomic Medical Laboratory, Calea Floreasca 35, RO-014453 Bucharest, Romania; (I.T.); (A.T.-C.); (D.S.)
| | - Danae Stambouli
- Cytogenomic Medical Laboratory, Calea Floreasca 35, RO-014453 Bucharest, Romania; (I.T.); (A.T.-C.); (D.S.)
| | - Sergiu Gladun
- Institute of Mother and Child, Str. Burebista 93, MD-2062 Chisinau, Moldova; (D.B.); (C.B.); (V.H.); (L.P.); (S.G.)
| | - Ninel Revenco
- “Nicolae Testemitanu” State University of Medicine and Pharmacy, Bd. Stefan cel Mare si Sfint 165, MD-2004 Chisinau, Moldova; (A.O.); (A.S.); (N.R.)
| | - Natalia Uşurelu
- Institute of Mother and Child, Str. Burebista 93, MD-2062 Chisinau, Moldova; (D.B.); (C.B.); (V.H.); (L.P.); (S.G.)
- Correspondence: (A.N.); (N.U.); or (C.D.); Tel.: +40-744-340-456 (C.D.)
| | - Calin Deleanu
- “Petru Poni” Institute of Macromolecular Chemistry, Romanian Academy, Aleea Grigore Ghica Voda 41A, RO-700487 Iasi, Romania;
- “C. D. Nenitescu” Centre of Organic Chemistry, Romanian Academy, Spl. Independentei 202B, RO-060023 Bucharest, Romania
- Correspondence: (A.N.); (N.U.); or (C.D.); Tel.: +40-744-340-456 (C.D.)
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Abstract
The application of MR spectroscopy (MRS) in pediatric brain disorders yields valued information on pathologic processes, such as ischemia, demyelination, gliosis, and neurodegeneration. Because these processes manifest in inborn errors of metabolism, the purposes of this article are to (1) describe the spectral changes that are associated with the relatively common metabolic disorders, with summaries of known spectroscopic features of these disorders; (2) offer suggestions for recognition and distinction of disorders; and (3) provide general guidelines for MRS implementation. Although many conditions have a similar presentation, MRS offers valuable information for the individual patient in diagnosis and therapy when integrated fully into the clinical setting.
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Affiliation(s)
- Kim M Cecil
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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Abstract
The risk assessment of compounds added to foods or taken as supplements is usually based on hazard characterization studies performed in animal test species. A large default uncertainty factor, or margin or exposure, is usually required to allow for possible species differences and human variability in the toxicokinetics and toxicodynamics of the compound. The development of biomarkers offers the potential to rationalize the risk assessment of amino acids, and to refine the extrapolation of data from animals to humans. The use of high resolution nuclear magnetic resonance spectroscopy applied to readily accessible biological fluids, such as urine and plasma, offers great potential for the identification of toxicologically relevant biomarkers in animal studies that can then be applied to studies in humans.
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Affiliation(s)
- Andrew G Renwick
- Clinical Pharmacology Group, University of Southampton, Biomedical Sciences Building, Southampton SO16 7PX, UK.
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Chemelli AP, Schocke M, Sperl W, Trieb T, Aichner F, Felber S. Magnetic resonance spectroscopy (MRS) in five patients with treated propionic acidemia. J Magn Reson Imaging 2000; 11:596-600. [PMID: 10862057 DOI: 10.1002/1522-2586(200006)11:6<596::aid-jmri4>3.0.co;2-p] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Propionic acidemia is an inherited disorder caused by a defect of propionyl CoA carboxylase. Untreated, propionic acidemia leads to metabolic decompensation and toxic encephalopathy. We report on the magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings in five children who were properly treated by protein restriction and carnitine supplementation, during a phase of clinically and metabolically stable conditions. The examinations were performed on a whole-body 1.5 T scanner. During the observation period, from 1992 to 1996 we employed long echo time single-voxel spectroscopy and chemical shift imaging in addition to a conventional MRI protocol. The two children with the longest delay before onset of therapy showed cerebral atrophy. MRS yielded elevated lactate peaks in four of the children. These results indicate that MRS can detect metabolic alterations in the brains of children with propionic acidemia during metabolically stable conditions. The presence of lactate could be caused by hampered aerobic oxidation within the citrate cycle due to intracellular elevated propionic metabolites.
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Affiliation(s)
- A P Chemelli
- Department of Radiology, University of Innsbruck, 6020 Innsbruck, Austria
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