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Wang W, Kou J, Zhang M, Wang T, Li W, Wang Y, Xie Q, Wei M. A metabonomic study to explore potential markers of asymptomatic hyperuricemia and acute gouty arthritis. J Orthop Surg Res 2023; 18:96. [PMID: 36782295 PMCID: PMC9926836 DOI: 10.1186/s13018-023-03585-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Acute gouty arthritis (AGA) is a metabolic disease with acute arthritis as its main manifestation. However, the pathogenesis of asymptomatic hyperuricemia (HUA) to AGA is still unclear, and metabolic markers are needed to early predict and diagnose. In this study, gas chromatography (GC)/liquid chromatography (LC)-mass spectrometry (MS) was used to reveal the changes of serum metabolites from healthy people to HUA and then to AGA, and to find the pathophysiological mechanism and biological markers. METHODS Fifty samples were included in AGA, HUA, and healthy control group, respectively. The metabolites in serum samples were detected by GC/LC-MS. According to the statistics of pairwise grouping, the statistically significant differential metabolites were obtained by the combination of multidimensional analysis and one-dimensional analysis. Search the selected metabolites in KEGG database, determine the involved metabolic pathways, and draw the metabolic pathway map in combination with relevant literature. RESULTS Using metabonomics technology, 23 different serum metabolic markers related to AGA and HUA were found, mainly related to uric acid metabolism and inflammatory response caused by HUA/AGA. Three of them are completely different from the previous gout studies, nine metabolites with different trends from conventional inflammation. CONCLUSIONS In conclusion, we analyzed 150 serum samples from AGA, HUA, and healthy control group by GC/LC-MS to explore the changes of these differential metabolites and metabolic pathways, suggesting that the disease progression may involve the changes of biomarkers, which may provide a basis for disease risk prediction and early diagnosis.
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Affiliation(s)
- Wei Wang
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610000 People’s Republic of China ,grid.263901.f0000 0004 1791 7667College of Medicine, Southwest Jiaotong University, North Section 1 No. 111, Second Ring Road, Chengdu, 610000 People’s Republic of China
| | - Jun Kou
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610000 People’s Republic of China ,grid.263901.f0000 0004 1791 7667College of Medicine, Southwest Jiaotong University, North Section 1 No. 111, Second Ring Road, Chengdu, 610000 People’s Republic of China
| | - Mingmei Zhang
- Department of Rheumatism and Immunology, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000 People’s Republic of China
| | - Tao Wang
- Department of Rheumatism and Immunology, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000 People’s Republic of China
| | - Wei Li
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610000 People’s Republic of China ,grid.263901.f0000 0004 1791 7667College of Medicine, Southwest Jiaotong University, North Section 1 No. 111, Second Ring Road, Chengdu, 610000 People’s Republic of China
| | - Yamen Wang
- grid.263901.f0000 0004 1791 7667College of Medicine, Southwest Jiaotong University, North Section 1 No. 111, Second Ring Road, Chengdu, 610000 People’s Republic of China ,Department of Rheumatism and Immunology, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000 People’s Republic of China
| | - Qingyun Xie
- Department of Orthopedics, General Hospital of Western Theater Command, Rongdu Avenue No. 270, Chengdu, 610000, People's Republic of China.
| | - Meng Wei
- Department of Rheumatism and Immunology, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China.
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Kwong AK, Wong SS, Rodenburg RJT, Smeitink J, Chan GCF, Fung C. Human d-lactate dehydrogenase deficiency by LDHD mutation in a patient with neurological manifestations and mitochondrial complex IV deficiency. JIMD Rep 2021; 60:15-22. [PMID: 34258137 PMCID: PMC8260477 DOI: 10.1002/jmd2.12220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND d-lactate, one of the isomers of lactate, exists in a low concentration in healthy individuals and it can be oxidized to pyruvate catalyzed by d-lactate dehydrogenase. Excessive amount of d-lactate causes d-lactate acidosis associated with neurological manifestations. METHODS AND RESULTS We report here a patient with developmental delay, cerebellar ataxia, and transient hepatomegaly. Enzyme analysis in the patient's skin fibroblast showed decreased mitochondrial complex IV activity. Using whole exome sequencing, we identified compound heterozygous variants in the LDHD gene, which encodes the d-lactate dehydrogenase, consisting of a splice site variant c.469+1dupG and a missense variant c.752C>T, p.(Thr251Met) which are pathogenic and likely pathogenic respectively according to the American College of Medical Genetics and Genomics (ACMG) classification. The serum d-lactate level was subsequently detected to be elevated (0.61 mmol/L, reference value: 0-0.25 mmol/L). CONCLUSION This is the third report on LDHD mutations associated with d-lactate elevation and was first reported to have decreased mitochondrial complex IV activity. The study provides more information on this rare metabolic condition but the association of LDHD deficiency with the clinical presentations requires further investigations.
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Affiliation(s)
- Anna Ka‐Yee Kwong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong SARChina
| | - Sheila Suet‐Na Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong SARChina
- Department of Paediatrics and Adolescent MedicineHong Kong Children's HospitalHong Kong SARChina
| | - Richard J. T. Rodenburg
- Radboud Centre for Mitochondrial Medicine, Department of PaediatricsRadboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical CentreNijmegenThe Netherlands
| | - Jan Smeitink
- Radboud Centre for Mitochondrial Medicine, Department of PaediatricsRadboud Institute for Molecular Life Sciences, Radboud University Nijmegen Medical CentreNijmegenThe Netherlands
| | - Godfrey Chi Fung Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong SARChina
- Department of Paediatrics and Adolescent MedicineHong Kong Children's HospitalHong Kong SARChina
| | - Cheuk‐Wing Fung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong SARChina
- Department of Paediatrics and Adolescent MedicineHong Kong Children's HospitalHong Kong SARChina
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Abstract
PURPOSE The renal excretion of uric acid is usually diminished in primary gout with respect to increased serum urate levels. To determine whether the renal excretion of uric acid precursors, hypoxanthine and xanthine, is also abnormal in primary gout, the concentrations of these purines were measured in plasma and 24-hour urine samples in normal subjects, in patients with primary gout and uric acid underexcretion, and in patients with enzyme deficiencies that are known to result in over-production of uric acid. SUBJECTS AND METHODS Three groups of subjects were studied: Group I consisted of 10 ambulatory healthy normal men; Group II consisted of 15 patients in whom primary gout was diagnosed; and Group III consisted of 10 patients with various enzyme defects known to produce an excessive synthesis of uric acid. In each subject, plasma and 24-hour urinary uric acid, hypoxanthine, xanthine, and creatinine concentrations were measured and the mean of three consecutive determinations was used. The fractional excretion of purine compounds was calculated from a formula. Hypoxanthine phosphoribosyltransferase, adenine phosphoribosyltransferase, and hemoglobin were also measured in each subject. RESULTS Plasma hypoxanthine and xanthine were increased in the two groups of patients compared with the control subjects. Urinary hypoxanthine and xanthine levels were reduced in gouty patients compared with control subjects, whereas levels were increased in patients with uric acid overproduction. A positive correlation was found between the renal clearances of uric acid, hypoxanthine, and xanthine. CONCLUSION The results indicate that the renal excretion of hypoxanthine and xanthine is severely impaired in most patients with primary gout.
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Affiliation(s)
- J G Puig
- Department of Internal Medicine, La Paz University Hospital, Universidad Autónoma, Madrid, Spain
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