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Redonnet-Vernhet I, Mercié P, Lebreton L, Blouin JM, Bronnimann D, Mesli S, Guibet C, Ribeiro E, Gensous N, Duffau P, Gouya L, Richard E. Preventing hyperhomocysteinemia using vitamin B 6 supplementation in Givosiran-treated acute intermittent porphyria: Highlights from a case report and brief literature review. Mol Genet Metab Rep 2024; 39:101076. [PMID: 38601120 PMCID: PMC11004984 DOI: 10.1016/j.ymgmr.2024.101076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
Acute hepatic porphyrias are inherited metabolic disorders of heme biosynthesis characterized by the accumulation of toxic intermediate metabolites responsible for disabling acute neurovisceral attacks. Givosiran is a newly approved siRNA-based treatment of acute hepatic porphyria targeting the first and rate-limiting δ-aminolevulinic acid synthase 1 (ALAS1) enzyme of heme biosynthetic pathway. We described a 72-year old patient who presented with severe inaugural neurological form of acute intermittent porphyria evolving for several years which made her eligible for givosiran administration. On initiation of treatment, the patient developed a major hyperhomocysteinemia (>400 μmol/L) which necessitated to discontinue the siRNA-based therapy. A thorough metabolic analysis in the patient suggests that hyperhomocysteinemia could be attributed to a functional deficiency of cystathionine β-synthase (CBS) enzyme induced by givosiran. Long-term treatment with vitamin B6, a cofactor of CBS, allowed to normalize homocysteinemia while givosiran treatment was maintained. We review the recently published cases of hyperhomocysteinemia in acute hepatic porphyria and its exacerbation under givosiran therapy. We also discuss the benefits of vitamin B6 supplementation in the light of hypothetic pathophysiological mechanisms responsible for hyperhomocysteinemia in these patients. Our results confirmed the importance of monitoring homocysteine metabolism and vitamin status in patients with acute intermittent porphyria in order to improve management by appropriate vitamin supplementation during givosiran treatment.
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Affiliation(s)
- Isabelle Redonnet-Vernhet
- Univ. Bordeaux, INSERM, MRGM, U1211, F-33076 Bordeaux, France
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
| | - Patrick Mercié
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
| | - Louis Lebreton
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
| | - Jean-Marc Blouin
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
| | - Didier Bronnimann
- Service de Médecine Interne et Maladies Infectieuses, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075, France
| | - Samir Mesli
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
| | - Claire Guibet
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
| | - Emmanuel Ribeiro
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
| | - Noémie Gensous
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
- Univ-Bordeaux, CNRS UMR5164 Immunoconcept, Bordeaux, France
| | - Pierre Duffau
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
- Univ-Bordeaux, CNRS UMR5164 Immunoconcept, Bordeaux, France
| | - Laurent Gouya
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
- Centre de Référence Maladies Rares Porphyries et anémies rares du métabolisme du fer, Centre Français des Porphyries, Hôpital Louis Mourier, AP-HP, Paris, France
| | - Emmanuel Richard
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
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Denimal D, Badiou S, Blin J, Bonnan M, Boullier A, Chauvin A, Dupont A, Diesnis R, Dupré T, Fabresse N, Gernez É, Imbard A, Kim I, Mondesert É, Niguet JP, Parant F, Redonnet-Vernhet I, Trillot N, Grzych G. Biomarkers for the diagnosis and monitoring of nitrous oxide intoxication: objectives and methodology of the SFBC Working Group. Ann Biol Clin (Paris) 2024; 81:585-590. [PMID: 38391163 DOI: 10.1684/abc.2023.1858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
The recreational use of nitrous oxide (N2O) is an emerging public health issue. Chronic N2O abuse may result in various clinical symptoms, encompassing neurological, psychiatric and cardiovascular outcomes. Despite the difficulties for the laboratory investigation of N2O intoxication, there is currently no guidelines in France to help both clinicians and biologists use appropriate biomarkers for the diagnosis and monitoring of patients with clinical symptoms potentially related to N2O intoxication. A multi-disciplinary Working Group, carried out under the auspices of the French Society of Clinical Biology (SFBC) and in collaboration with the French Societies of Emergency Medicine (SFMU), Analytical Toxicology (SFTA), Hemostasis and Thrombosis (SFTH), Vitamins and Biofactors (SFVB), and the French Federation of Neurology (FFN), was recently implemented to elaborate practical guidelines. The methodology of the Working Group is based on the critical analysis of the literature, and raising concerns and objectives are grouped into five working packages. The present manuscript primarily aims to expound upon the methodology and objectives of the ongoing SFBC Working Group on N2O.
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Affiliation(s)
- Damien Denimal
- Department of Clinical Biochemistry, Dijon Bourgogne University Hospital & INSERM UMR 1231, Center for Translational and Molecular Medicine, Dijon, France
| | - Stéphanie Badiou
- Department of Biochemistry, University Hospital of Montpellier & PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Justine Blin
- Department of Biochemistry, University Hospital of Nantes & INSERM, IMAD, Nantes, France
| | - Mickael Bonnan
- Department of Neurology, Hospital of Saint-Denis, Saint-Denis, France
| | - Agnès Boullier
- Department of Biochemistry, Amiens-Picardie University Hospital & MP3CV-UR7517, CURS-University of Picardie Jules Verne, Amiens, France
| | - Anthony Chauvin
- Department of Emergency, Lariboisiere Hospital, Assistance Publique-Hôpitaux de Paris & Inserm U942 MASCOT, University of Paris, Paris, France
| | - Annabelle Dupont
- Department of Hematology and Transfusion, University Hospital of Lille, Lille, France
| | - Rémy Diesnis
- Department of Emergency, Hospital of Roubaix, Roubaix, France
| | - Thierry Dupré
- Department of Biochemistry, Bichat Hospital, Assistance Publique-Hôpitaux de Paris & Inserm U1149, University of Paris, Paris, France
| | - Nicolas Fabresse
- Department of Pharmacokinetics and Toxicology, La Timone University Hospital, Marseille, France
| | - Émeline Gernez
- Department of Hormonology, Metabolism, Nutrition and Oncology, University Hospital of Lille, Lille, France
| | - Apolline Imbard
- Department of Biochemistry, Assistance Publique-Hôpitaux de Paris & Paris Saclay University, Paris, France
| | - Isabelle Kim
- Department of Hormonology, Metabolism, Nutrition and Oncology, University Hospital of Lille, Lille, France
| | - Étienne Mondesert
- Department of Biochemistry, University Hospital of Montpellier, Montpellier, France
| | - Jean-Paul Niguet
- Department of Neurology, Groupement des Hôpitaux de l'Institut Catholique de Lille, Catholic University of Lille, Lille, France
| | - François Parant
- Department of Biology, Lyon-Sud Hospital, University Hospital of Lyon, Pierre-Bénite, France
| | - Isabelle Redonnet-Vernhet
- Department of Biochemistry, Pellegrin Hospital, University Hospital of Bordeaux & Inserm U1211, University of Bordeaux, France
| | - Nathalie Trillot
- Department of Hematology and Transfusion, University Hospital of Lille, Lille, France
| | - Guillaume Grzych
- Department of Hormonology, Metabolism, Nutrition and Oncology, University Hospital of Lille, Lille, France
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Redonnet-Vernhet I, Duval F, Carla L, Nadal L, Ouallet JC, Solé G, Mesli S, Guibet C, Daveluy A, Le-Masson G. À propos de 12 cas d’intoxication au protoxyde d’azote diagnostiqués au CHU de Bordeaux en 2021 : nécessité du dosage de l’homocystéine totale plasmatique, biomarqueur de la carence cellulaire en vitamine B12. Therapie 2022. [DOI: 10.1016/j.therap.2022.10.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Mütze U, Gleich F, Garbade SF, Plisson C, Aldámiz-Echevarría L, Arrieta F, Ballhausen D, Zielonka M, Petković Ramadža D, Baumgartner MR, Cano A, García Jiménez MC, Dionisi-Vici C, Ješina P, Blom HJ, Couce ML, Meavilla Olivas S, Mention K, Mochel F, Morris AAM, Mundy H, Redonnet-Vernhet I, Santra S, Schiff M, Servais A, Vitoria I, Huemer M, Kožich V, Kölker S. Postauthorization safety study of betaine anhydrous. J Inherit Metab Dis 2022; 45:719-733. [PMID: 35358327 DOI: 10.1002/jimd.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/06/2022]
Abstract
Patient registries for rare diseases enable systematic data collection and can also be used to facilitate postauthorization safety studies (PASS) for orphan drugs. This study evaluates the PASS for betaine anhydrous (Cystadane), conducted as public private partnership (PPP) between the European network and registry for homocystinurias and methylation defects and the marketing authorization holder (MAH). Data were prospectively collected, 2013-2016, in a noninterventional, international, multicenter, registry study. Putative adverse and severe adverse events were reported to the MAH's pharmacovigilance. In total, 130 individuals with vitamin B6 nonresponsive (N = 54) and partially responsive (N = 7) cystathionine beta-synthase (CBS) deficiency, as well as 5,10-methylenetetrahydrofolate reductase (MTHFR; N = 21) deficiency and cobalamin C (N = 48) disease were included. Median (range) duration of treatment with betaine anhydrous was 6.8 (0-9.8) years. The prescribed betaine dose exceeded the recommended maximum (6 g/day) in 49% of individuals older than 10 years because of continued dose adaptation to weight; however, with disease-specific differences (minimum: 31% in B6 nonresponsive CBS deficiency, maximum: 67% in MTHFR deficiency). Despite dose escalation no new or potential risk was identified. Combined disease-specific treatment decreased mean ± SD total plasma homocysteine concentrations from 203 ± 116 to 81 ± 51 μmol/L (p < 0.0001), except in MTHFR deficiency. Recommendations for betaine anhydrous dosage were revised for individuals ≥ 10 years. PPPs between MAH and international scientific consortia can be considered a reliable model for implementing a PASS, reutilizing well-established structures and avoiding data duplication and fragmentation.
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Affiliation(s)
- Ulrike Mütze
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | - Florian Gleich
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | - Sven F Garbade
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | | | | | - Francisco Arrieta
- Endocrinology & Nutrition, Metabolic Congenital Disease, H.U. Ramon y Cajal, Madrid, Spain
| | - Diana Ballhausen
- Pediatric Unit for Metabolic Diseases, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Matthias Zielonka
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
| | - Danijela Petković Ramadža
- Department of Pediatrics, University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Matthias R Baumgartner
- Division of Metabolism and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Aline Cano
- Centre de Référence des Maladies Héréditaires du Métabolisme, CHU La Timone Enfants, Marseille, France
| | | | - Carlo Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Pavel Ješina
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Henk J Blom
- Department of Clinical Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus Medical Center, Rotterdam, Netherlands
| | - Maria Luz Couce
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Service of Neonatology, Department of Pediatrics, Hospital Clínico Universitario de Santiago, CIBERER, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Silvia Meavilla Olivas
- Pediatrics, Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Karine Mention
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Jeanne de Flandre, Lille, France
| | - Fanny Mochel
- Ap.HP, Sorbonne University, Reference Center for Adult Neurometabolic Diseases, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Andrew A M Morris
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Trust, Manchester, UK
| | - Helen Mundy
- Evelina London Children's Hospital, London, UK
| | - Isabelle Redonnet-Vernhet
- Endocrinology, Nutrition and Metabolic Diseases, Haut-Lévêque Hospital, Bordeaux University, Bordeaux, France
| | - Saikat Santra
- Department of Clinical Inherited Metabolic Disorders, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Manuel Schiff
- Necker Hospital, APHP, Reference Center for Inborn Error of Metabolism and Filière G2M, Pediatrics Department, University of Paris, Paris, France
- Inserm UMR_S1163, Institut Imagine, Paris, France
| | - Aude Servais
- Nephrology and Transplantation, MAMEA Reference Center, Necker hospital, APHP, Paris, France
| | - Isidro Vitoria
- Unit of Metabolic Disorders, Universitary Hospital La Fe, Valencia, Spain
| | - Martina Huemer
- Division of Metabolism and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
- Department of Pediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria
| | - Viktor Kožich
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Stefan Kölker
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital, Heidelberg, Germany
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Amoedo ND, Sarlak S, Obre E, Esteves P, Bégueret H, Kieffer Y, Rousseau B, Dupis A, Izotte J, Bellance N, Dard L, Redonnet-Vernhet I, Punzi G, Rodrigues MF, Dumon E, Mafhouf W, Guyonnet-Dupérat V, Gales L, Palama T, Bellvert F, Dugot-Senan N, Claverol S, Baste JM, Lacombe D, Rezvani HR, Pierri CL, Mechta-Grigoriou F, Thumerel M, Rossignol R. Targeting the mitochondrial trifunctional protein restrains tumor growth in oxidative lung carcinomas. J Clin Invest 2021; 131:133081. [PMID: 33393495 DOI: 10.1172/jci133081] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/21/2020] [Indexed: 12/15/2022] Open
Abstract
Metabolic reprogramming is a common hallmark of cancer, but a large variability in tumor bioenergetics exists between patients. Using high-resolution respirometry on fresh biopsies of human lung adenocarcinoma, we identified 2 subgroups reflected in the histologically normal, paired, cancer-adjacent tissue: high (OX+) mitochondrial respiration and low (OX-) mitochondrial respiration. The OX+ tumors poorly incorporated [18F]fluorodeoxy-glucose and showed increased expression of the mitochondrial trifunctional fatty acid oxidation enzyme (MTP; HADHA) compared with the paired adjacent tissue. Genetic inhibition of MTP altered OX+ tumor growth in vivo. Trimetazidine, an approved drug inhibitor of MTP used in cardiology, also reduced tumor growth and induced disruption of the physical interaction between the MTP and respiratory chain complex I, leading to a cellular redox and energy crisis. MTP expression in tumors was assessed using histology scoring methods and varied in negative correlation with [18F]fluorodeoxy-glucose incorporation. These findings provide proof-of-concept data for preclinical, precision, bioenergetic medicine in oxidative lung carcinomas.
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Affiliation(s)
- Nivea Dias Amoedo
- CELLOMET, Bordeaux, France.,INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Saharnaz Sarlak
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Emilie Obre
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Pauline Esteves
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Hugues Bégueret
- Bordeaux University, Bordeaux, France.,Pathology Department, Haut-Lévèque Hospital, CHU Bordeaux, Bordeaux, France
| | - Yann Kieffer
- Stress and Cancer Laboratory, Curie Institute - INSERM U830, Paris, France
| | - Benoît Rousseau
- INSERM U1211, Bordeaux, France.,Transgenic Animal Facility A2, University of Bordeaux, Bordeaux, France
| | - Alexis Dupis
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Julien Izotte
- INSERM U1211, Bordeaux, France.,Transgenic Animal Facility A2, University of Bordeaux, Bordeaux, France
| | - Nadège Bellance
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Laetitia Dard
- CELLOMET, Bordeaux, France.,INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Isabelle Redonnet-Vernhet
- CELLOMET, Bordeaux, France.,INSERM U1211, Bordeaux, France.,Biochemistry Department, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Giuseppe Punzi
- Laboratory of Biochemistry and Molecular Biology, University of Bari,Bari, Italy
| | | | - Elodie Dumon
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | - Walid Mafhouf
- Bordeaux University, Bordeaux, France.,INSERM U1035, Bordeaux, France
| | | | - Lara Gales
- Laboratoire d'Ingénierie des Systèmes Biologiques et des Procédés (LISBP), Institut National des Sciences Appliquées (INSA)/CNRS 5504 - UMR INSA/Institut National de la Recherche Agronomique (INRA) 792, Toulouse, France
| | - Tony Palama
- Laboratoire d'Ingénierie des Systèmes Biologiques et des Procédés (LISBP), Institut National des Sciences Appliquées (INSA)/CNRS 5504 - UMR INSA/Institut National de la Recherche Agronomique (INRA) 792, Toulouse, France
| | - Floriant Bellvert
- Laboratoire d'Ingénierie des Systèmes Biologiques et des Procédés (LISBP), Institut National des Sciences Appliquées (INSA)/CNRS 5504 - UMR INSA/Institut National de la Recherche Agronomique (INRA) 792, Toulouse, France
| | | | - Stéphane Claverol
- Bordeaux University, Bordeaux, France.,Functional Genomics Center (CGFB), Proteomics Facility, Bordeaux, France
| | - Jean-Marc Baste
- Thoracic Surgery, Haut-Lévèque Hospital, CHU Bordeaux, Bordeaux, France
| | - Didier Lacombe
- INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
| | | | - Ciro Leonardo Pierri
- Laboratory of Biochemistry and Molecular Biology, University of Bari,Bari, Italy
| | | | - Matthieu Thumerel
- Thoracic Surgery, Haut-Lévèque Hospital, CHU Bordeaux, Bordeaux, France
| | - Rodrigue Rossignol
- CELLOMET, Bordeaux, France.,INSERM U1211, Bordeaux, France.,Bordeaux University, Bordeaux, France
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6
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Toquet S, Spodenkiewicz M, Douillard C, Maillot F, Arnoux JB, Damaj L, Odent S, Moreau C, Redonnet-Vernhet I, Mesli S, Servais A, Noel E, Charriere S, Rigalleau V, Lavigne C, Kaphan E, Roubertie A, Besson G, Bigot A, Servettaz A, Mochel F, Garnotel R. Adult-onset diagnosis of urea cycle disorders: Results of a French cohort of 71 patients. J Inherit Metab Dis 2021; 44:1199-1214. [PMID: 34014557 DOI: 10.1002/jimd.12403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/19/2022]
Abstract
Urea cycle disorders (UCD) are rare diseases that usually affect neonates or young children. During decompensations, hyperammonemia is neurotoxic, leading to severe symptoms and even coma and death if not treated rapidly. The aim was to describe a cohort of patients with adult onset of UCDs in a multicentric, retrospective and descriptive study of French adult patients with a diagnosis after 16 years of age of UCDs due to a deficiency in one of the 6 enzymes (arginase, ASL, ASS, CPS1, NAGS, OTC) or the two transporters (ORNT1 or citrin). Seventy-one patients were included (68% female, 32% male). The diagnosis was made in the context of (a) a metabolic decompensation (42%), (b) family history (55%), or (c) chronic symptoms (3%). The median age at diagnosis was 33 years (range 16-86). Eighty-nine percent of patients were diagnosed with OTC deficiency, 7% CPS1 deficiency, 3% HHH syndrome and 1% argininosuccinic aciduria. For those diagnosed during decompensations (including 23 OTC cases, mostly female), 89% required an admission in intensive care units. Seven deaths were attributed to UCD-6 decompensations and 1 epilepsy secondary to inaugural decompensation. This is the largest cohort of UCDs diagnosed in adulthood, which confirms the triad of neurological, gastrointestinal and psychiatric symptoms during hyperammonemic decompensations. We stress that females with OTC deficiency can be symptomatic. With 10% of deaths in this cohort, UCDs in adults remain a life-threatening condition. Physicians working in adult care must be aware of late-onset presentations given the implications for patients and their families.
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Affiliation(s)
- Ségolène Toquet
- Service de Médecine Interne, Hôpital Robert Debré, CHU Reims, France
| | | | - Claire Douillard
- Service d'Endocrinologie et Métabolismes, Hôpital Claude Huriez, Centre de Référence des Maladies Héréditaires du métabolisme, CHU Lille, France
| | - François Maillot
- Service de Médecine Interne, Hôpital Bretonneau, CHRU de Tours, France
| | - Jean-Baptiste Arnoux
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker-Enfants Malades, CHU Paris, France
| | - Lena Damaj
- Service de Pédiatrie, CHU Hôpital Sud, Rennes, France
| | - Sylvie Odent
- Service de Génétique Clinique, CHU Hôpital Sud, Rennes, France
| | - Caroline Moreau
- Service de Biochimie et Toxicologie, CHU Pontchaillou, Rennes, France
| | | | - Samir Mesli
- Laboratoire de Biochimie, Hôpital Pellegrin, CHU Bordeaux, France
| | - Aude Servais
- Service de Néphrologie adulte, Hôpital Necker-Enfants Malades, CHU Paris, France
| | - Esther Noel
- Service de Médecine Interne, Hôpital Universitaire de Strasbourg, CHRU Strasbourg, France
| | - Sybill Charriere
- Fédération d'endocrinologie, maladies métaboliques, diabète et nutrition, Hôpital Louis Pradel, Centre de Référence des Maladies Héréditaires du Métabolisme, Bron, France
| | | | | | - Elsa Kaphan
- Pôle de Neurosciences Cliniques, CHU Timone, AP-HM, Marseille, France
| | - Agathe Roubertie
- Département de neuropédiatrie, Hôpital Gui de Chauliac, CHU Montpellier, France
| | | | - Adrien Bigot
- Service de Médecine Interne, Hôpital Bretonneau, CHRU de Tours, France
| | - Amélie Servettaz
- Service de Médecine Interne, Hôpital Robert Debré, CHU Reims, France
| | - Fanny Mochel
- Département de génétique, Hôpital Pitié-Salpêtrière, CHU Paris, France
| | - Roselyne Garnotel
- Laboratoire de Biochimie-Pharmacologie-Toxicologie, CHU Reims, France
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7
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Marelli C, Lavigne C, Stepien KM, Janssen MCH, Feillet F, Kožich V, Jesina P, Schule R, Kessler C, Redonnet-Vernhet I, Regnier A, Burda P, Baumgartner M, Benoist JF, Huemer M, Mochel F. Clinical and molecular characterization of adult patients with late-onset MTHFR deficiency. J Inherit Metab Dis 2021; 44:777-786. [PMID: 33089527 DOI: 10.1002/jimd.12323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 11/07/2022]
Abstract
5,10-Methylenetetrahydrofolate reductase (MTHFR) deficiency usually presents as a severe neonatal disease. This study aimed to characterize natural history, biological and molecular data, and response to treatment of patients with late-onset MTHFR deficiency. The patients were identified through the European Network and Registry for Homocystinuria and Methylation Defects and the Adult group of the French Society for Inherited Metabolic Diseases; data were retrospectively colleted. To identify juvenile to adult-onset forms of the disease, we included patients with a diagnosis established after the age of 10 years. We included 14 patients (median age at diagnosis: 32 years; range: 11-54). At onset (median age: 20 years; range 9-38), they presented with walking difficulties (n = 8), cognitive decline (n = 3) and/or seizures (n = 3), sometimes associated with mild mental retardation (n = 6). During the disease course, symptoms were almost exclusively neurological with cognitive dysfunction (93%), gait disorders (86%), epilepsy (71%), psychiatric symptoms (57%), polyneuropathy (43%), and visual deficit (43%). Mean diagnostic delay was 14 years. Vascular events were observed in 28% and obesity in 36% of the patients. One patient remained asymptomatic at the age of 55 years. Upon treatment, median total homocysteine decreased (from 183 μmol/L, range 69-266, to 90 μmol/L, range 20-142) and symptoms improved (n = 9) or stabilized (n = 4). Missense pathogenic variants in the C-terminal regulatory domain of the protein were over-represented compared to early-onset cases. Residual MTHFR enzymatic activity in skin fibroblasts (n = 4) was rather high (17%-58%). This series of patients with late-onset MTHFR deficiency underlines the still unmet need of a prompt diagnosis of this treatable disease.
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Affiliation(s)
- Cecilia Marelli
- Expert Centre for Neurogenetic Diseases and Adult Mitochondrial and Metabolic Diseases, Univ Montpellier, CHU, Montpellier, France
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
| | - Christian Lavigne
- Internal Medicine Department, Angers University Hospital, Angers, France
| | - Karolina M Stepien
- Adult Inherited Metabolic Diseases, Salford Royal NHS Foundation Trust, Salford Care Organisation, Northern Care Alliance, Salford, UK
| | - Mirian C H Janssen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Francois Feillet
- Reference Center for Inborn Errors of Metabolism, Pediatric unit, University Hospital of Nancy, Nancy, France
- INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, Nancy, France
| | - Viktor Kožich
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital in Prague, Praha 2, Czech Republic
| | - Pavel Jesina
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital in Prague, Praha 2, Czech Republic
| | - Rebecca Schule
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Christoph Kessler
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Isabelle Redonnet-Vernhet
- lNSERM U1211, Université de Bordeaux, Bordeaux, France
- Laboratoire de Biochimie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- Centre de référence pour les maladies mitochondriales de l'enfant à l'adulte (CARAMMEL), Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Adeline Regnier
- Department of General Practice, Faculty of Medicine of Clermont-Ferrand, Clermont-Ferrand, France
| | - Patricie Burda
- Division of Metabolism and Children's Research Center, University Children's Hospital, Zürich, Switzerland
| | - Matthias Baumgartner
- Division of Metabolism and Children's Research Center, University Children's Hospital, Zürich, Switzerland
| | - Jean-Francois Benoist
- Biochemistry Laboratory Robert-Debré University Hospital, APHP, Paris, France
- LYPSIS2, Université Paris-Saclay, Chatenay-Malabry, France
| | - Martina Huemer
- Division of Metabolism and Children's Research Center, University Children's Hospital, Zürich, Switzerland
- Department of Paediatrics Landeskrankenhaus Bregenz, Austria
| | - Fanny Mochel
- APHP, La Pitié-Salpêtrière University Hospital, Department of Genetics, Paris, France
- Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
- APHP, La Pitié-Salpêtrière University Hospital, Reference Center for Adult Neurometabolic diseases, Paris, France
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8
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Nguyen TL, Nokin MJ, Terés S, Tomé M, Bodineau C, Galmar O, Pasquet JM, Rousseau B, van Liempd S, Falcon-Perez JM, Richard E, Muzotte E, Rezvani HR, Priault M, Bouchecareilh M, Redonnet-Vernhet I, Calvo J, Uzan B, Pflumio F, Fuentes P, Toribio ML, Khatib AM, Soubeyran P, Murdoch PDS, Durán RV. Downregulation of Glutamine Synthetase, not glutaminolysis, is responsible for glutamine addiction in Notch1-driven acute lymphoblastic leukemia. Mol Oncol 2021; 15:1412-1431. [PMID: 33314742 PMCID: PMC8096784 DOI: 10.1002/1878-0261.12877] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/21/2020] [Accepted: 12/09/2020] [Indexed: 01/03/2023] Open
Abstract
The cellular receptor Notch1 is a central regulator of T-cell development, and as a consequence, Notch1 pathway appears upregulated in > 65% of the cases of T-cell acute lymphoblastic leukemia (T-ALL). However, strategies targeting Notch1 signaling render only modest results in the clinic due to treatment resistance and severe side effects. While many investigations reported the different aspects of tumor cell growth and leukemia progression controlled by Notch1, less is known regarding the modifications of cellular metabolism induced by Notch1 upregulation in T-ALL. Previously, glutaminolysis inhibition has been proposed to synergize with anti-Notch therapies in T-ALL models. In this work, we report that Notch1 upregulation in T-ALL induced a change in the metabolism of the important amino acid glutamine, preventing glutamine synthesis through the downregulation of glutamine synthetase (GS). Downregulation of GS was responsible for glutamine addiction in Notch1-driven T-ALL both in vitro and in vivo. Our results also confirmed an increase in glutaminolysis mediated by Notch1. Increased glutaminolysis resulted in the activation of the mammalian target of rapamycin complex 1 (mTORC1) pathway, a central controller of cell growth. However, glutaminolysis did not play any role in Notch1-induced glutamine addiction. Finally, the combined treatment targeting mTORC1 and limiting glutamine availability had a synergistic effect to induce apoptosis and to prevent Notch1-driven leukemia progression. Our results placed glutamine limitation and mTORC1 inhibition as a potential therapy against Notch1-driven leukemia.
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Affiliation(s)
- Tra Ly Nguyen
- Institut Européen de Chimie et Biologie, INSERM U1218, Université de Bordeaux, Pessac, France
| | - Marie-Julie Nokin
- Institut Européen de Chimie et Biologie, INSERM U1218, Université de Bordeaux, Pessac, France
| | - Silvia Terés
- Institut Européen de Chimie et Biologie, INSERM U1218, Université de Bordeaux, Pessac, France
| | - Mercedes Tomé
- Centro Andaluz de Biología Molecular y Medicina Regenerativa - CABIMER, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Universidad Pablo de Olavide, Seville, Spain.,Angiogenesis and Cancer Microenvironment Laboratory INSERM U1029, Université de Bordeaux, Pessac, France
| | - Clément Bodineau
- Institut Européen de Chimie et Biologie, INSERM U1218, Université de Bordeaux, Pessac, France.,Centro Andaluz de Biología Molecular y Medicina Regenerativa - CABIMER, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Universidad Pablo de Olavide, Seville, Spain
| | - Oriane Galmar
- Institut Européen de Chimie et Biologie, INSERM U1218, Université de Bordeaux, Pessac, France
| | | | - Benoit Rousseau
- Service Commun des Animaleries, University of Bordeaux, France
| | - Sebastian van Liempd
- Exosomes Laboratory and Platform of Metabolomics, CIC bioGUNE, CIBERehd, Derio, Spain
| | - Juan Manuel Falcon-Perez
- Exosomes Laboratory and Platform of Metabolomics, CIC bioGUNE, CIBERehd, Derio, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Elodie Richard
- Institut Bergonié, INSERM U1218, University of Bordeaux, France
| | | | | | - Muriel Priault
- Institut de Biochimie et Génétique Cellulaires, CNRS UMR 5095, Université de Bordeaux, France
| | - Marion Bouchecareilh
- Bordeaux Research in Translational Oncology, INSERM U1053, Université de Bordeaux, France
| | - Isabelle Redonnet-Vernhet
- Maladies Héréditaires du Métabolisme, Laboratoire de Biochimie, Hôpital Pellegrin, CHU Bordeaux, France
| | - Julien Calvo
- UMR967, Inserm, CEA, Université Paris 7, Université Paris 11, Fontenay-aux-Roses, France
| | - Benjamin Uzan
- UMR967, Inserm, CEA, Université Paris 7, Université Paris 11, Fontenay-aux-Roses, France
| | - Françoise Pflumio
- UMR967, Inserm, CEA, Université Paris 7, Université Paris 11, Fontenay-aux-Roses, France
| | - Patricia Fuentes
- Centro de Biología Molecular "Severo Ochoa", Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Spain
| | - Maria L Toribio
- Centro de Biología Molecular "Severo Ochoa", Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Spain
| | - Abdel-Majid Khatib
- Angiogenesis and Cancer Microenvironment Laboratory INSERM U1029, Université de Bordeaux, Pessac, France
| | | | - Piedad Del Socorro Murdoch
- Centro Andaluz de Biología Molecular y Medicina Regenerativa - CABIMER, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Universidad Pablo de Olavide, Seville, Spain.,Departamento de Bioquímica Vegetal y Biología Molecular, Universidad de Sevilla, Spain
| | - Raúl V Durán
- Institut Européen de Chimie et Biologie, INSERM U1218, Université de Bordeaux, Pessac, France.,Centro Andaluz de Biología Molecular y Medicina Regenerativa - CABIMER, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Universidad Pablo de Olavide, Seville, Spain
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9
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Rucheton B, Ducint D, Machenaud J, Thierry M, Amintas S, de Verneuil H, Mesli S, Redonnet-Vernhet I. Dosage par couplage LC-MS/MS du guanidino-acétate et de la créatine urinaires : optimisation de la technique par suppression de l’étape de dérivatisation. Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Treiber G, Baillet-Blanco L, Hugo M, Pupier E, Redonnet-Vernhet I, Cambos S, Rigalleau V. Comment on Almurdhi et al. Reduced Lower-Limb Muscle Strength and Volume in Patients With Type 2 Diabetes in Relation to Neuropathy, Intramuscular Fat, and Vitamin D Levels. Diabetes Care 2016;39:441-447. Diabetes Care 2016; 39:e183. [PMID: 27660128 DOI: 10.2337/dc16-1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Guillaume Treiber
- Nutrition and Diabetology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Laurence Baillet-Blanco
- Nutrition and Diabetology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Marie Hugo
- Nutrition and Diabetology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Emilie Pupier
- Nutrition and Diabetology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Sophie Cambos
- Nutrition and Diabetology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Vincent Rigalleau
- Nutrition and Diabetology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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11
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Carrozzo R, Verrigni D, Rasmussen M, de Coo R, Amartino H, Bianchi M, Buhas D, Mesli S, Naess K, Born AP, Woldseth B, Prontera P, Batbayli M, Ravn K, Joensen F, Cordelli DM, Santorelli FM, Tulinius M, Darin N, Duno M, Jouvencel P, Burlina A, Stangoni G, Bertini E, Redonnet-Vernhet I, Wibrand F, Dionisi-Vici C, Uusimaa J, Vieira P, Osorio AN, McFarland R, Taylor RW, Holme E, Ostergaard E. Succinate-CoA ligase deficiency due to mutations in SUCLA2 and SUCLG1: phenotype and genotype correlations in 71 patients. J Inherit Metab Dis 2016; 39:243-52. [PMID: 26475597 DOI: 10.1007/s10545-015-9894-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/04/2015] [Accepted: 09/08/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The encephalomyopathic mtDNA depletion syndrome with methylmalonic aciduria is associated with deficiency of succinate-CoA ligase, caused by mutations in SUCLA2 or SUCLG1. We report here 25 new patients with succinate-CoA ligase deficiency, and review the clinical and molecular findings in these and 46 previously reported patients. PATIENTS AND RESULTS Of the 71 patients, 50 had SUCLA2 mutations and 21 had SUCLG1 mutations. In the newly-reported 20 SUCLA2 patients we found 16 different mutations, of which nine were novel: two large gene deletions, a 1 bp duplication, two 1 bp deletions, a 3 bp insertion, a nonsense mutation and two missense mutations. In the newly-reported SUCLG1 patients, five missense mutations were identified, of which two were novel. The median onset of symptoms was two months for patients with SUCLA2 mutations and at birth for SUCLG1 patients. Median survival was 20 years for SUCLA2 and 20 months for SUCLG1. Notable clinical differences between the two groups were hepatopathy, found in 38% of SUCLG1 cases but not in SUCLA2 cases, and hypertrophic cardiomyopathy which was not reported in SUCLA2 patients, but documented in 14% of cases with SUCLG1 mutations. Long survival, to age 20 years or older, was reported in 12% of SUCLA2 and in 10% of SUCLG1 patients. The most frequent abnormality on neuroimaging was basal ganglia involvement, found in 69% of SUCLA2 and 80% of SUCLG1 patients. Analysis of respiratory chain enzyme activities in muscle generally showed a combined deficiency of complexes I and IV, but normal histological and biochemical findings in muscle did not preclude a diagnosis of succinate-CoA ligase deficiency. In five patients, the urinary excretion of methylmalonic acid was only marginally elevated, whereas elevated plasma methylmalonic acid was consistently found. CONCLUSIONS To our knowledge, this is the largest study of patients with SUCLA2 and SUCLG1 deficiency. The most important findings were a significantly longer survival in patients with SUCLA2 mutations compared to SUCLG1 mutations and a trend towards longer survival in patients with missense mutations compared to loss-of-function mutations. Hypertrophic cardiomyopathy and liver involvement was exclusively found in patients with SUCLG1 mutations, whereas epilepsy was much more frequent in patients with SUCLA2 mutations compared to patients with SUCLG1 mutations. The mutation analysis revealed a number of novel mutations, including a homozygous deletion of the entire SUCLA2 gene, and we found evidence of two founder mutations in the Scandinavian population, in addition to the known SUCLA2 founder mutation in the Faroe Islands.
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Affiliation(s)
- Rosalba Carrozzo
- Unit of Muscular and Neurodegenerative Diseases, Laboratory of Molecular Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Daniela Verrigni
- Unit of Muscular and Neurodegenerative Diseases, Laboratory of Molecular Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Magnhild Rasmussen
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Rene de Coo
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Hernan Amartino
- Servicio de Neurología Infantil, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Marzia Bianchi
- Unit of Muscular and Neurodegenerative Diseases, Laboratory of Molecular Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Daniela Buhas
- Department of Medical Genetics, Montreal Children's Hospital, Montréal, Quebéc, Canada
| | - Samir Mesli
- Biochemistry, CHU de Bordeaux, Bordeaux, France
| | - Karin Naess
- Department of Laboratory Medicine and Centre for Inherited Metabolic Diseases, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Alfred Peter Born
- Department of Pediatrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Berit Woldseth
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Paolo Prontera
- Centro di Riferimento Regionale di Genetica Medica, Azienda Ospedaliera di Perugia, CREO, Perugia, Italy
| | - Mustafa Batbayli
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kirstine Ravn
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Fróði Joensen
- Department of Pediatrics, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Duccio M Cordelli
- U.O. Neuropsichiatria Infantile - Franzoni, Policlinico S. Orsola Malpighi, Bologna, Italy
| | | | - Mar Tulinius
- Department of Pediatrics, University of Gothenburg, The Queen Silvia's Children Hospital, Gothenburg, Sweden
| | - Niklas Darin
- Department of Pediatrics, University of Gothenburg, The Queen Silvia's Children Hospital, Gothenburg, Sweden
| | - Morten Duno
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Philippe Jouvencel
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital, Bordeaux, France
| | - Alberto Burlina
- Division of Inherited Metabolic Diseases, Department of Pediatrics, University Hospital of Padua, Padua, Italy
| | - Gabriela Stangoni
- Centro di Riferimento Regionale di Genetica Medica, Azienda Ospedaliera di Perugia, CREO, Perugia, Italy
| | - Enrico Bertini
- Unit of Muscular and Neurodegenerative Diseases, Laboratory of Molecular Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Flemming Wibrand
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Carlo Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Johanna Uusimaa
- Institute of Clinical Medicine/Department of Paediatrics, Finland and Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Paivi Vieira
- Institute of Clinical Medicine/Department of Paediatrics, Finland and Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Andrés Nascimento Osorio
- Unidad de patología neuromuscular, Servicio de Neurología, Hospital Sant Joan de Déu. Hospital Sant Joan de Déu and CIBERER, ISCIII, Barcelona, Spain
| | - Robert McFarland
- Wellcome Trust Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Robert W Taylor
- Wellcome Trust Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Elisabeth Holme
- Department of Clinical Chemistry, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Elsebet Ostergaard
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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12
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Fossard G, Blond E, Balsat M, Morisset S, Giraudier S, Escoffre-Barbe M, Labussière-Wallet H, Heiblig M, Bert A, Etienne M, Drai J, Sobh M, Redonnet-Vernhet I, Lega JC, Mahon FX, Etienne G, Nicolini FE. Hyperhomocysteinemia and high doses of nilotinib favor cardiovascular events in chronic phase Chronic Myelogenous Leukemia patients. Haematologica 2015; 101:e86-90. [PMID: 26635034 DOI: 10.3324/haematol.2015.135103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Gaëlle Fossard
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite
| | - Emilie Blond
- Laboratory of biochemistry, Centre Hospitalier Lyon Sud, Pierre Bénite INSERM U1060, CarMeN Laboratory, Lyon 1 University, INRA 1235, Oullins
| | - Marie Balsat
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite
| | - Stéphane Morisset
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite
| | - Stéphane Giraudier
- Laboratory of Hematology, Hôpital Henri Mondor, Créteil Groupe Fi-LMC, Hôpital Haut Lévêque, Pessac, France
| | - Martine Escoffre-Barbe
- Hematology department, Hôpital Pontchaillou, Rennes Groupe Fi-LMC, Hôpital Haut Lévêque, Pessac, France
| | | | - Maël Heiblig
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite
| | - Arthur Bert
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite
| | - Madeleine Etienne
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite Groupe Fi-LMC, Hôpital Haut Lévêque, Pessac, France
| | - Jocelyne Drai
- Laboratory of biochemistry, Centre Hospitalier Lyon Sud, Pierre Bénite INSERM U1060, CarMeN Laboratory, Lyon 1 University, INRA 1235, Oullins
| | - Mohamad Sobh
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite
| | | | | | - François-Xavier Mahon
- Département d'hématologie, Institut Bergonié, Bordeaux Groupe Fi-LMC, Hôpital Haut Lévêque, Pessac, France
| | - Gabriel Etienne
- Département d'hématologie, Institut Bergonié, Bordeaux Groupe Fi-LMC, Hôpital Haut Lévêque, Pessac, France
| | - Franck Emmanuel Nicolini
- Hematology department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite Inserm U1052, Centre de Recherche en Cancérologie de Lyon Groupe Fi-LMC, Hôpital Haut Lévêque, Pessac, France
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13
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Fakhry A, Redonnet-Vernhet I, Sabourdy F, Elbaz M, Caussé E. [Pulmonary embolism in young adults. Think of homocysteine]. Ann Cardiol Angeiol (Paris) 2014; 63:111-113. [PMID: 24613005 DOI: 10.1016/j.ancard.2014.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 01/02/2014] [Indexed: 06/03/2023]
Abstract
Two cases of severe pulmonary embolism in young adults are presented. Biological investigation disclosed hyperhomocysteinemia. This highlights the great interest of homocysteine quantification in such clinical events.
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Affiliation(s)
- A Fakhry
- Service de cardiologie, centre hospitalier Castres-Mazamet, 81100 Castres, France
| | | | - F Sabourdy
- Service de biochimie, IFB, CHU Purpan, TSA 40031, 31059 Toulouse cedex 9, France
| | - M Elbaz
- Service de cardiologie, CHU Rangueil, TSA 50032, 31059 Toulouse cedex 9, France
| | - E Caussé
- Service de biochimie, CHU Rangueil, 1, avenue J.-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
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14
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Lamireau D, Feghali H, Redonnet-Vernhet I, Mesli S, Carles D, Brissaud O. [Acute fatty liver in pregnancy: revealing fetal fatty acid oxidation disorders]. Arch Pediatr 2012; 19:277-81. [PMID: 22325456 DOI: 10.1016/j.arcped.2011.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 08/20/2011] [Accepted: 12/23/2011] [Indexed: 12/20/2022]
Abstract
Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome are serious maternal illnesses occurring in the third trimester of pregnancy with significant perinatal and maternal mortality. AFLP may result from mitochondrial defects in the beta-oxidation of fatty acids, in particular a deficiency of the long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) in the fetus. Clinical findings in AFLP vary and its diagnosis is complicated by a significant overlap in clinical and biochemical features with HELLP syndrome. We report the case of 2 siblings who died, the first one in the neonatal period of asphyxia with multivisceral presentation and the second one from sudden death at 7 months. Autopsy of the latter infant revealed hepatic steatosis associated with cardiomyopathy, which led to suspicion of a fatty acid oxidation deficiency. Mutation analysis demonstrated that both children were homozygous for the common mutation c.1528G>C and the parents were heterozygous for this same mutation. This case demonstrates the importance of screening mothers with acute fatty liver disease of pregnancy and their children at birth for a metabolic disease. This article proposes several metabolic tests for mother and child suspected of having beta-oxidation of a fatty acid disorder.
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Affiliation(s)
- D Lamireau
- Unité de réanimation pédiatrique, hôpital Pellegrin-Enfants, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux-cedex, France.
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Rubin S, Le Piffer AL, Rougier MB, Korobelnik JF, Goizet C, Marchal C, Mesli S, Redonnet-Vernhet I, Gonzalez C, Gin H, Rigalleau V. P200 Cécité corticale régressive sous diététique chez un adulte porteur de phénylcétonurie. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70267-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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16
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Baruteau J, Levade T, Redonnet-Vernhet I, Mesli S, Bloom MC, Broué P. Hypoketotic hypoglycemia with myolysis and hypoparathyroidism: an unusual association in medium chain acyl-CoA desydrogenase deficiency (MCADD). J Pediatr Endocrinol Metab 2009; 22:1175-7. [PMID: 20333879 DOI: 10.1515/jpem.2009.22.12.1175] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Medium-chain acyl-CoA deshydrogenase deficiency (MCADD) is the most frequent disorder of mitochondrial fatty acid oxidation (MFAO). We report a 3 year-old girl with enterovirus viremia who was referred after 36 hours of fasting with hypoketotic hypoglycemic coma and myolysis. Evolution was complicated by acute renal failure, increased serum levels of transaminases and hypoparathyroidism. Diagnosis of MCADD was supported by typical plasma acylcarnitine and urinary organic acid profiles, and confirmed by homozygosity for the common missense A985G mutation. Whereas myolysis is frequent in MFAO defects, it is rarely reported as a major accompanying sign in MCADD. Hypoparathyroidism has been previously reported in some MFAO deficiencies but has never been mentioned in association with MCADD. We review the possible mechanisms of hypoparathyroidism in MFAO deficiencies. Parathyroid glands and pancreas dysfunction should be screened in MFAO defects as these organs could be implicated in the clinical spectrum of the frequent A985G MCADD disease-causing mutation.
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Affiliation(s)
- Julien Baruteau
- APHP, Hôpital Robert Debré, Service de Neurologie Pédiatrique et Maladies Héréditaires du Métabolisme, Paris, France.
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17
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Laleye A, Alao MJ, Gbessi G, Adjagba M, Marche M, Coupry I, Redonnet-Vernhet I, Lepreux S, Ayivi B, Darboux RB, Lacombe D, Arveiler B. Tumoral calcinosis due to GALNT3 C.516-2A >T mutation in a black African family. Genet Couns 2008; 19:183-92. [PMID: 18618993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Familial Tumoral Calcinosis (FTC) is a rare autosomal recessive disorder of the phosphocalcic metabolism caused by mutations in the FGF23 or GALNT3 genes. We have identified a Beninese family in which two brothers present FTC caused by a homozygous A>T transversion at the acceptor splice site in intron 1 of GALNT3 gene. We report on the clinical, biochemical, histopathological and molecular spectrum of the disorder in this family. The particularly severe phenotype, the amelogenesis imperfecta, and the carbapatite deposit observed in these patients, seem to be characteristic of our observations.
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Affiliation(s)
- A Laleye
- Unité de Biologie Humaine, Faculté des Sciences de la Santé, Cotonou, Bénin.
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18
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Lidove O, Bekri S, Goizet C, Khau Van Kien A, Aractingi S, Knebelmann B, Choukroun G, Tsimaratos M, Redonnet-Vernhet I, Lacombe D, Jaussaud R. Maladie de Fabry: propositions d'ungroupe d'experts français concernant le diagnostic, le traitement et le suivi des patients. Presse Med 2007; 36:1084-97. [PMID: 17276649 DOI: 10.1016/j.lpm.2007.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fabry disease is a rare and under-recognized disease associated with an altered X-linked gene controlling hydrolase alpha-galactosidase A activity. This mutation impairs the glycosphingolipid metabolism. A multisystemic disease with a highly variable clinical presentation, its principal symptom is acroparesthesia. Manifestations of Fabry disease occur mostly in hemizygous males but also in heterozygous females. Before enzyme replacement therapy was available, life expectancy was about 50 years in men and 70 years in women. Early diagnosis is essential to prevent irreversible organ damage. Diagnosis is based on an assay of alpha-galactosidase A activity in male patients and on genetic analysis in female patients. Prognosis is related principally to three complications: involvement of the central nervous system, kidneys, and heart. Management of Fabry patients should in all cases combine symptomatic therapy and regular clinical, laboratory and morphological follow-up by specialists in genetic metabolic diseases. Enzyme replacement therapy should be considered in all adult male patients and should probably begin early. In adult heterozygous female patients and in children, this treatment should be considered only for patients with severe pain, organ damage, or central nervous system, kidney, or heart involvement. After a proband is identified, a genealogical tree should be used to identify other affected members of the family.
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Géronimi F, Richard E, Redonnet-Vernhet I, Lamrissi-Garcia I, Lalanne M, Ged C, Moreau-Gaudry F, De Verneuil H. Highly efficient lentiviral gene transfer in CD34+ and CD34+/38-/lin- cells from mobilized peripheral blood after cytokine prestimulation. Stem Cells 2004; 21:472-80. [PMID: 12832700 DOI: 10.1634/stemcells.21-4-472] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because mobilized peripheral blood (mPB) represents an attractive source of cells for gene therapy, we investigated lentiviral gene transfer in CD34(+) cells and the stem/progenitor-cell-enriched CD34(+)/38(-)/lin(-) cell subset isolated from mPB. In this study, we used an optimized third-generation self-inactivating lentiviral vector containing both the central polypurine tract and the woodchuck hepatitis posttranscriptional regulatory element sequences and encoding enhanced green fluorescent protein (EGFP) under the control of the elongation factor lalpha promoter. This lentivector was first used to compare multiplicity of infection (MOI)-dependent gene transfer efficiency in cord blood (CB) versus mPB CD34(+)-derived cells, colony-forming cells (CFCs), and long-term culture-initiating cells (LTC-ICs). Results showed a difference in the percentage of transduced cells particularly significant at low MOIs. A plateau was reached where 15% and 25% of CB and mPB cells, respectively, remained refractory to lentiviral trans-duction. Effects of a cytokine prestimulation period (18 hours) with interleukin-3, stem cell factor, Flt-3 ligand, and thrombopoietin were then analyzed in total cells, CFCs, and LTC-ICs derived from mPB CD34(+) cells. Transduction levels in those conditions demonstrated a two- and fourfold increase in CFCs and LTC-ICs, respectively, compared with unstimulated (<3 hours) control cells. Moreover, using the same transduction protocol, we were able to efficiently transduce CD34(+)/38(-)/lin(-) cells isolated from mPB, with up to >85% of colonies derived from LTC-ICs expressing EGFP and gene transfer levels remaining stable for 10 weeks in liquid culture. We therefore demonstrate a highly efficient gene transfer in this therapeutically relevant target cell population.
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20
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Richard E, Géronimi F, Lalanne M, Ged C, Redonnet-Vernhet I, Lamrissi-Garcia I, Gerson SL, de Verneuil H, Moreau-Gaudry F. A bicistronic SIN-lentiviral vector containing G156A MGMT allows selection and metabolic correction of hematopoietic protoporphyric cell lines. J Gene Med 2003; 5:737-47. [PMID: 12950064 DOI: 10.1002/jgm.407] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Erythropoietic protoporphyria (EPP) is an inherited disease characterised by a ferrochelatase (FECH) deficiency, the latest enzyme of the heme biosynthetic pathway, leading to the accumulation of toxic protoporphyrin in the liver, bone marrow and spleen. We have previously shown that a successful gene therapy of a murine model of the disease was possible with lentiviral vectors even in the absence of preselection of corrected cells, but lethal irradiation of the recipient was necessary to obtain an efficient bone marrow engraftment. To overcome a preconditioning regimen, a selective growth advantage has to be conferred to the corrected cells. METHODS We have developed a novel bicistronic lentiviral vector that contains the human alkylating drug resistance mutant O(6)-methylguanine DNA methyltransferase (MGMT G156A) and FECH cDNAs. We tested their capacity to protect hematopoietic cell lines efficiently from alkylating drug toxicity and correct enzymatic deficiency. RESULTS EPP lymphoblastoid (LB) cell lines, K562 and cord-blood-derived CD34(+) cells were transduced at a low multiplicity of infection (MOI) with the bicistronic constructs. Resistance to O(6)-benzylguanine (BG)/N,N'-bis(2-chloroethyl)-N-nitrosourea (BCNU) was clearly shown in transduced cells, leading to the survival and expansion of provirus-containing cells. Corrected EPP LB cells were selectively amplified, leading to complete restoration of enzymatic activity and the absence of protoporphyrin accumulation. CONCLUSIONS This study demonstrates that a lentiviral vector including therapeutic and G156A MGMT genes followed by BG/BCNU exposure can lead to a full metabolic correction of deficient cells. This vector might form the basis of new EPP mouse gene therapy protocols without a preconditioning regimen followed by in vivo selection of corrected hematopoietic stem cells.
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21
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Géronimi F, Richard E, Lamrissi-Garcia I, Lalanne M, Ged C, Redonnet-Vernhet I, Moreau-Gaudry F, de Verneuil H. Lentivirus-mediated gene transfer of uroporphyrinogen III synthase fully corrects the porphyric phenotype in human cells. J Mol Med (Berl) 2003; 81:310-20. [PMID: 12721665 DOI: 10.1007/s00109-003-0438-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2003] [Accepted: 03/14/2003] [Indexed: 11/25/2022]
Abstract
Congenital erythropoietic porphyria (CEP) is an inherited disease due to a deficiency in the uroporphyrinogen III synthase, the fourth enzyme of the heme biosynthesis pathway. It is characterized by accumulation of uroporphyrin I in the bone marrow, peripheral blood and other organs. The prognosis of CEP is poor, with death often occurring early in adult life. For severe transfusion-dependent cases, when allogeneic cell transplantation cannot be performed, the autografting of genetically modified primitive/stem cells may be the only alternative. In vitro gene transfer experiments have documented the feasibility of gene therapy via hematopoietic cells to treat this disease. In the present study lentiviral transduction of porphyric cell lines and primary CD34(+) cells with the therapeutic human uroporphyrinogen III synthase (UROS) cDNA resulted in both enzymatic and metabolic correction, as demonstrated by the increase in UROS activity and the suppression of porphyrin accumulation in transduced cells. Very high gene transfer efficiency (up to 90%) was achieved in both cell lines and CD34(+) cells without any selection. Expression of the transgene remained stable over long-term liquid culture. Furthermore, gene expression was maintained during in vitro erythroid differentiation of CD34(+) cells. Therefore the use of lentiviral vectors is promising for the future treatment of CEP patients by gene therapy.
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Affiliation(s)
- F Géronimi
- INSERM E 0217, Université Victor Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France
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22
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Affiliation(s)
- Pascale Barat
- Departmentof Paediatrics, Universitaire de Bordeaux, France.
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Benelli C, Fouque F, Redonnet-Vernhet I, Malgat M, Fontan D, Marsac C, Dey R. A novel Y243S mutation in the pyruvate dehydrogenase El alpha gene subunit: correlation with thiamine pyrophosphate interaction. J Inherit Metab Dis 2002; 25:325-7. [PMID: 12227466 DOI: 10.1023/a:1016570828778] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We identified a new Y243S mutation in the X-linked E1 alpha-PDH gene in a patient with pyruvate dehydrogenase complex (PDHc) deficiency. The activity in cultured fibroblasts was very low even in the presence of high thiamine pyrophosphate (TPP) concentrations, indicating that the defect could be due to decreased affinity of PDHc for TPP.
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Affiliation(s)
- C Benelli
- INSERM U530, Hĵpital Necker, Paris, France
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24
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Lasseur C, Parrot F, Delmas Y, Level C, Ged C, Redonnet-Vernhet I, Montaudon D, Combe C, Chauveau P. Impact of high-flux/high-efficiency dialysis on folate and homocysteine metabolism. J Nephrol 2001; 14:32-5. [PMID: 11281342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
High-flux/high-efficiency (HF/HE) dialysis may have detrimental effects on micro-nutrients and water-soluble vitamins, such as vitamin B6, whose levels are lowered. Folate deficiency may increase cardiovascular risk through an increase in homocysteine (Hcy) serum levels. We therefore investigated the effects of dialysis with a high-flux (HF) membrane on folate and Hcy metabolism. Twelve patients without any folate supplementation, receiving dialysis with a low-flux membrane prior to the study (TO), were switched to dialysis using a HF triacetate membrane for four months (T1, T2, T3, T4) and received an oral daily folate supplementation during the two last months (T3, T4). Mean predialysis plasma folate levels fell dramatically after one month of HF dialysis (T1) and remained significantly lower than the initial level (p<0.05) at T2. Hcy concentrations were high in all patients at TO (mean 47.3 +/- 17.6 microM, normal range 5 to 15 microM). They did not change during the first two months of the study but dropped steeply after the beginning of oral folate supplementation. Folate supplementation should be used in HF/HE dialysis to avoid folate depletion. The combination of folate supplementation and HF/HE may lower Hcy levels and reduce cardiovascular morbidity and mortality in these patients.
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Affiliation(s)
- C Lasseur
- Service of Nephrology and Hemodialysis, Saint-André Hospital, Bordeaux, France.
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25
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Letellier T, Durrieu G, Malgat M, Rossignol R, Antoch J, Deshouillers JM, Coquet M, Lacombe D, Netter JC, Pedespan JM, Redonnet-Vernhet I, Mazat JP. Statistical analysis of mitochondrial pathologies in childhood: identification of deficiencies using principal component analysis. J Transl Med 2000; 80:1019-30. [PMID: 10908147 DOI: 10.1038/labinvest.3780107] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Mitochondrial pathologies are a heterogeneous group of metabolic disorders that are frequently characterized by anomalies of oxidative phosphorylation, especially in the respiratory chain. The identification of these anomalies may involve many investigations, and biochemistry is a main tool. However, considering the whole set of biochemical data, the interpretation of the results by the traditionally used statistical methods remains complex and does not always lead to an unequivocal conclusion about the presence or absence of a respiratory chain defect. This arises from three main problems: (a) the absence of an a priori-defined control population, because the determination of the control values are derived from the whole set of investigated patients, (b) the small size of the population studied, (c) the large number of variables collected, each of which creates a wide variability. To cope with these problems, the principal component analysis (PCA) has been applied to the biochemical data obtained from 35 muscle biopsies of children suspected of having a mitochondrial disease. This analysis makes it possible for each respiratory chain complex to distinguish between different subsets within the whole population (normal, deficient, and, in between, borderline subgroups of patients) and to detect the most discriminating variables. PCA of the data of all complexes together showed that mitochondrial diseases in this population were mainly caused by multiple deficits in respiratory chain complexes. This analysis allows the definition of a new subgroup of newborns, which have high respiratory chain complex activity values. Our results show that the PCA method, which simultaneously takes into account all of the concerned variables, allows the separation of patients into subgroups, which may help clinicians make their diagnoses.
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Affiliation(s)
- T Letellier
- INSERM EMI 9929, Université Bordeaux II, Rabat-Léon, France
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26
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Affiliation(s)
- F Parrot
- Laboratoire de Biochimie, Hôpital Pellegrin, Bordeaux, France.
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27
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Redonnet-Vernhet I, Rouanet F, Pedespan JM, Hocke C, Parrot F. A successful pregnancy in a heterozygote for OTC deficiency treated with sodium phenylbutyrate. Neurology 2000; 54:1008. [PMID: 10691008 DOI: 10.1212/wnl.54.4.1008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Redonnet-Vernhet I, Chatelut M, Salvayre R, Levade T. A novel lysosomal acid lipase gene mutation in a patient with cholesteryl ester storage disease. Hum Mutat 1998; 11:335-6. [PMID: 9554751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The molecular defects in the gene encoding the lysosomal acid lipase (LAL) were investigated in an adult male patient affected with cholesteryl ester storage disease (CESD), an autosomal recessive disorder associated with LAL deficient activity. Nucleotide sequencing of amplified LAL genomic DNA or reverse-transcribed mRNA demonstrated that this patient was a compound heterozygote for a previously reported mutation, a G-->A transition at position -1 of the exon 8 splice donor site, resulting in skipping of the complete exon 8, and for a C-->T substitution at position 233 (exon 3), which introduces a premature in-frame termination codon. This yet undescribed mutation, which results in the loss of 89% of LAL amino acids, is very likely to abolish the LAL catalytic activity.
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Affiliation(s)
- I Redonnet-Vernhet
- Laboratoire de Biochimie Médicale, Maladies Métaboliques, INSERM U. 466, CHU Rangueil, Toulouse, France
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Redonnet-Vernhet I, Chatelut M, Buscail L, Mahuran DJ, Salvayre R, Levade T. A619→G substitution in the HEXB gene is not a deleterious mutation, but a frequent polymorphism. Hum Mutat 1998. [DOI: 10.1002/humu.13801101110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Redonnet-Vernhet I, Chatelut M, Basile JP, Salvayre R, Levade T. Cholesteryl ester storage disease: relationship between molecular defects and in situ activity of lysosomal acid lipase. Biochem Mol Med 1997; 62:42-9. [PMID: 9367797 DOI: 10.1006/bmme.1997.2626] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The molecular defects in the LIPA gene encoding the lysosomal acid lipase (LAL) were investigated in two unrelated patients affected with cholesteryl ester storage disease (CESD), an autosomal recessive disorder associated with LAL-deficient activity. In cell lysates from both patients there was a severely reduced LAL activity. In a female patient, nucleotide sequencing of amplified LAL genomic DNA or reverse-transcribed mRNA demonstrated that she was a compound heterozygote for two previously reported mutations, a G --> A transition at position -1 of the exon 8 splice donor site, resulting in skipping of the complete exon 8, and a C923 --> T substitution leading to the replacement of His274 to Tyr. The second, male CESD patient was heterozygous for the splice junction mutation and a yet undescribed C --> T substitution at position 233, which introduces a premature in-frame termination codon. The functional consequences of these genetic alterations were evaluated for the first time by studying the catabolic turnover of radiolabeled cholesteryl oleate in intact cells. A lower in situ residual LAL activity was found in cells carrying the stop codon mutation than in cells having the His274 --> Tyr substitution. Since the severely reduced LAL activity was seen in cells from an adult patient with a mild CESD, we conclude that there is no simple direct correlation between the LAL molecular lesions and the biochemical and clinical phenotypes.
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Affiliation(s)
- I Redonnet-Vernhet
- "Maladies Métaboliques,", INSERM U. 466, CHU Rangueil, F-31403 Toulouse, France
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Redonnet-Vernhet I, Mahuran DJ, Salvayre R, Dubas F, Levade T. Significance of two point mutations present in each HEXB allele of patients with adult GM2 gangliosidosis (Sandhoff disease) homozygosity for the Ile207-->Val substitution is not associated with a clinical or biochemical phenotype. Biochim Biophys Acta 1996; 1317:127-33. [PMID: 8950198 DOI: 10.1016/s0925-4439(96)00044-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The molecular defects in the HEXB gene encoding the common beta-subunit of lysosomal beta-hexosaminidase A (beta-Hex A, alpha beta) and beta-Hex B (beta beta) were investigated in a Portuguese family affected with late onset Sandhoff disease (GM2-gangliosidosis variant 0). This family comprised two unaffected daughters and three affected sibs who developed at about age 17 cerebellar ataxia and mental deficiency. Their parents were consanguineous and clinically asymptomatic. There was no detectable beta-Hex B activity and a profound reduction in the activity of beta-Hex A in the leukocytes and transformed lymphoid cell lines from the affected sibs. The expected intermediate values were observed in the parents as well as in one daughter and her children. Western analysis revealed the presence of reduced, but detectable amounts of mature beta-chain protein in cell lysates from the probands and intermediate levels in the parents. Nucleotide sequencing of amplified, reverse-transcribed beta-chain mRNA demonstrated the presence of two single point mutations: an A619 to G transition in exon 5 (Ile207-->Val), and a G1514 to A transition in exon 13 (Arg505-->Gln). Both of these two mutations have been previously linked to the adult form of Sandhoff disease in compound heterozygote patients. All three affected sibs were found to be homoallelic for both mutations. Interestingly, while the mother was heterozygous for each mutation, the father was homozygote for the A619-->G substitution and heterozygote for the G1514-->A transition. Since the father is homozygote for the A619-->G mutation but expresses a biochemical phenotype consistent with a carrier of Sandhoff disease and is clinically asymptomatic, this substitution is likely a neutral mutation. We confirmed this hypothesis by finding this transition present in 4 of 30 alleles from normal individuals. We conclude that homozygosity for the G1514-->A mutation is exclusively responsible for the adult form of Sandhoff disease in this family, and that the A619-->G substitution is not a deleterious mutation but rather a common HEXB polymorphism.
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Affiliation(s)
- I Redonnet-Vernhet
- Laboratoire de Biochimie Médicale, CJF INSERM 9206, Institut Louis Bugnard, Toulouse, France
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32
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Redonnet-Vernhet I, Ploos van Amstel JK, Jansen RP, Wevers RA, Salvayre R, Levade T. Uneven X inactivation in a female monozygotic twin pair with Fabry disease and discordant expression of a novel mutation in the alpha-galactosidase A gene. J Med Genet 1996; 33:682-8. [PMID: 8863162 PMCID: PMC1050704 DOI: 10.1136/jmg.33.8.682] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We describe two female monozygotic (MZ) twins heterozygous for Fabry disease, an X linked disorder resulting from the deficient activity of alpha-galactosidase A. While one of the twins was clinically affected, the other was asymptomatic. Enzymatic assay of alpha-galactosidase in blood leucocytes, skin fibroblasts, Epstein-Barr virus transformed lymphoid cell lines, and hair follicles of the twins and their parents confirmed the heterozygous status of the twins and indicated that Fabry disease had occurred as a result of a de novo mutation. The son of the unaffected twin sister was shown to be hemizygous. Molecular analysis of the alpha-galactosidase A gene permitted the identification of an as yet undescribed point mutation at position 10182 of exon 5 which causes an Asp to Asn substitution at codon 231. Single strand conformation polymorphism (SSCP) analysis again showed the heterozygous status of the twins and a normal pattern in their parents. The basis for the discordant expression of this d novo mutation in the twins was investigated by studying their X inactivation status. Analysis of the inactive X specific methylation at the androgen receptor gene showed unbalanced inactivation in the twins' fibroblasts and in opposite directions. While the maternally derived X chromosome was preferentially active in the asymptomatic twin, the paternal X chromosome was active in the other, affected twin and was found in her hemizygotic nephew. These data suggest that the paternal X chromosome carries the de novo alpha-galactosidase A mutation and that uneven X inactivation is the underlying mechanism for disease expression in this novel female MZ twin pair. This is the first documented case of female twins discordant for Fabry disease.
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Affiliation(s)
- I Redonnet-Vernhet
- CJF INSERM 9206, Laboratoire de Biochimie Médicale, Maladies Métaboliques, Institut Louis Bugnard, CHU Rangueil, Toulouse, France
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