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Wenger O, Brown M, Smith B, Chowdhury D, Crosby AH, Baple EL, Yoder M, Laxen W, Tortorelli S, Strauss KA. Biochemical phenotype and its relationship to treatment in 16 individuals with PCCB c.1606A > G (p.Asn536Asp) variant propionic acidemia. Mol Genet Metab 2020; 131:316-324. [PMID: 33127324 DOI: 10.1016/j.ymgme.2020.09.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Abstract
Propionic acidemia (PA) is caused by inherited deficiency of mitochondrial propionyl-CoA carboxylase (PCC) and results in significant neurodevelopmental and cardiac morbidity. However, relationships among therapeutic intervention, biochemical markers, and disease progression are poorly understood. Sixteen individuals homozygous for PCCB c.1606A > G (p.Asn536Asp) variant PA participated in a two-week suspension of therapy. Standard metabolic markers (plasma amino acids, blood spot methylcitrate, plasma/urine acylcarnitines, urine organic acids) were obtained before and after stopping treatment. These same markers were obtained in sixteen unaffected siblings. Echocardiography and electrocardiography were obtained from all subjects. We characterized the baseline biochemical phenotype of untreated PCCB c.1606A > G homozygotes and impact of treatment on PCC deficiency biomarkers. Therapeutic regimens varied widely. Suspension of therapy did not significantly alter branched chain amino acid levels, their alpha-ketoacid derivatives, or urine ketones. Carnitine supplementation significantly increased urine propionylcarnitine and its ratio to total carnitine. Methylcitrate blood spot and urine levels did not correlate with other biochemical measures or cardiac outcomes. Treatment of PCCB c.1606A > G homozygotes with protein restriction, prescription formula, and/or various dietary supplements has a limited effect on core biomarkers of PCC deficiency. These patients require further longitudinal study with standardized approaches to better understand the relationship between biomarkers and disease burden.
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Affiliation(s)
- Olivia Wenger
- New Leaf Clinic, PO Box 336, 16014 East Chestnut Street, Mount Eaton, OH, 44691, USA; Department of Pediatrics, Akron Children's Hospital, 214 West Bowery Street, Akron, OH 44308, USA.
| | - Miraides Brown
- Rebecca Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
| | - Brandon Smith
- Department of Pediatrics, Akron Children's Hospital, 214 West Bowery Street, Akron, OH 44308, USA
| | | | - Andrew H Crosby
- Institute of Biomedical and Clinical Science, Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
| | - Emma L Baple
- Institute of Biomedical and Clinical Science, Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
| | - Mark Yoder
- Northeast Ohio Medical University, Rootstown, OH, USA
| | - William Laxen
- Biochemical Genetics Laboratory, Mayo Clinic, Rochester, MN, USA
| | | | - Kevin A Strauss
- Clinic for Special Children, Strasburg, PA, USA; Department of Pediatrics, Penn Medicine-Lancaster General Hospital, Lancaster, PA, USA; Departments of Pediatrics and Molecular, Cell & Cancer Biology, University of Massachusetts School of Medicine, Worcester, MA, USA
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Jiang NM, Cowan M, Moonah SN, Petri WA. The Impact of Systemic Inflammation on Neurodevelopment. Trends Mol Med 2018; 24:794-804. [PMID: 30006148 PMCID: PMC6110951 DOI: 10.1016/j.molmed.2018.06.008] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 12/13/2022]
Abstract
Inflammatory mediators affect the brain during development. Neurodevelopmental disorders such as autism spectrum disorders, cognitive impairment, cerebral palsy, epilepsy, and schizophrenia have been linked to early life inflammation. Recent advances have shown the effects of systemic inflammation on children's neurodevelopment. We discuss the potential mechanisms by which inflammatory molecules can exert their effects on the developing brain and consider the roles of MHC class I molecules, the HPA axis, glial cells, and monoamine metabolism. Methods to prevent the effects of cytokine imbalance may lead to the development of new therapeutics for neuropsychiatric disorders. Future research should focus on identifying at-risk individuals and early effective interventions to prevent long-term neurodevelopmental disabilities.
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Affiliation(s)
- Nona M Jiang
- University of Virginia, Department of Medicine, Division of Infectious Diseases, MR4 Building Room 2115, Charlottesville, VA 22908, USA
| | - Maureen Cowan
- University of Virginia, Department of Medicine, Division of Infectious Diseases, MR4 Building Room 2115, Charlottesville, VA 22908, USA
| | - Shannon N Moonah
- University of Virginia, Department of Medicine, Division of Infectious Diseases, MR4 Building Room 2115, Charlottesville, VA 22908, USA
| | - William A Petri
- University of Virginia, Department of Medicine, Division of Infectious Diseases, MR4 Building Room 2115, Charlottesville, VA 22908, USA.
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