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Zeharia A, Ebberink MS, Wanders RJA, Waterham HR, Gutman A, Nissenkorn A, Korman SH. A novel PEX12 mutation identified as the cause of a peroxisomal biogenesis disorder with mild clinical phenotype, mild biochemical abnormalities in fibroblasts and a mosaic catalase immunofluorescence pattern, even at 40 degrees C. J Hum Genet 2007; 52:599-606. [PMID: 17534573 DOI: 10.1007/s10038-007-0157-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2006] [Accepted: 05/07/2007] [Indexed: 10/23/2022]
Abstract
Mutations in 12 different PEX genes can cause a generalized peroxisomal biogenesis disorder with clinical phenotypes ranging from Zellweger syndrome to infantile Refsum disease. To identify the specific PEX gene to be sequenced, complementation analysis is first performed in fibroblasts using catalase immunofluorescence. A patient with a relatively mild phenotype of infantile cholestasis, hypotonia and motor delay had elevated plasma very long-chain fatty acids and bile acid precursors, but fibroblast studies revealed normal or only mildly abnormal peroxisomal parameters and mosaic catalase immunofluorescence. This mosaicism persisted even when the incubation temperature was increased from 37 degrees C to 40 degrees C, a maneuver previously shown to abolish mosaicism by exacerbating peroxisomal dysfunction. As mosaicism precludes complementation analysis, a candidate gene approach was employed. After PEX1 sequencing was unrewarding, PEX12 sequencing revealed homozygosity for a novel c.102A>T (p.R34S) missense mutation affecting a partially conserved residue in the N-terminal region important for localization to peroxisomes. Transfection of patient fibroblasts with wild-type PEX12 cDNA confirmed that a PEX12 defect was the basis for the PBD. Homozygosity for c.102A>T was identified in a second patient of similar ethnic origin also presenting with a mild phenotype. PEX12 is a highly probable candidate gene for direct sequencing in the context of a mild clinical phenotype with mosaicism and minimally abnormal peroxisomal parameters in fibroblasts.
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Affiliation(s)
- Avraham Zeharia
- Day Hospitalization Unit, Schneider Children's Medical Center of Israel, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel
| | - Merel S Ebberink
- Departments of Clinical Chemistry and Pediatrics, Academic Medical Centre, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Ronald J A Wanders
- Departments of Clinical Chemistry and Pediatrics, Academic Medical Centre, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Hans R Waterham
- Departments of Clinical Chemistry and Pediatrics, Academic Medical Centre, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Alisa Gutman
- Department of Clinical Biochemistry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Andreea Nissenkorn
- Pediatric Neurology Unit, Safra Children's Hosptial, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Stanley H Korman
- Department of Clinical Biochemistry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
- Metabolic Diseases Unit, Division of Pediatrics, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, Israel.
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2
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Brites P, A. Wanders RJ, Waterham HR. The mouse as a model to understand peroxisomal biogenesis and its disorders. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.ddmod.2004.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3
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Yang YJ, Choi MH, Paik MJ, Yoon HR, Chung BC. Gas chromatographic-mass spectrometric determination of plasma saturated fatty acids using pentafluorophenyldimethylsilyl derivatization. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 2000; 742:37-46. [PMID: 10892582 DOI: 10.1016/s0378-4347(00)00098-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An improved method for the detection of 11 saturated fatty acids (SFAs) including C12:0-C26:0 (even numbers only), C17:0, C19:0 and C23:0 in human plasma by gas chromatography-mass spectrometry (GC-MS) with a stable isotope internal standard as d3-stearic acid is described. This procedure was based on acidic treatment, liquid-liquid extraction, and chemical derivatization prior to instrumental analysis. Eleven pentafluorophenyldimethylsilyl-SFA derivatives were well separated without any interfering peaks in plasma samples. The characteristic ions at M-15, constituting the base peaks in the electron impact mass spectra for 11 SFAs, permitted their sensitive detection by GC-MS in the selected ion monitoring (SIM) mode. The SIM responses were linear with correlation coefficients varying from 0.993 to 0.999 in the concentration range of 0.05 to approximately 50 microg/ml for the 11 SFAs. The detection limits for SIM of the SFAs varied in the range of 0.05 to approximately 10.0 pg. When applied to the plasma samples of normal subjects and patients with X-linked adenoleukodystrophy, which is one of the hereditary peroxisomal disorders, the present method enabled us to determine the SFAs with good sensitivity and good overall precision and accuracy within the concentration ranges of 0.14 to approximately 82.35 micromol/l.
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Affiliation(s)
- Y J Yang
- Bioanalysis & Biotransformation Research Center, KIST, Cheongryang, Seoul, South Korea
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4
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Steinberg SJ, El�ioglu N, Slade CM, Sankaralingam A, Dennis N, Mohammed SN, Fensom AH. Peroxisomal disorders: Clinical and biochemical studies in 15 children and prenatal diagnosis in 7 families. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/(sici)1096-8628(19990827)85:5<502::aid-ajmg14>3.0.co;2-t] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Balistreri WF. Inborn errors of bile acid biosynthesis and transport. Novel forms of metabolic liver disease. Gastroenterol Clin North Am 1999; 28:145-72, vii. [PMID: 10198783 DOI: 10.1016/s0889-8553(05)70048-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Defective bile acid biosynthesis, metabolism, and transport can now be delineated in a wide variety of disease states. This ability to recognize specific aberrations, such as the documented inborn errors in bile acid biosynthesis manifesting as neonatal cholestasis, offers new opportunities for therapeutic intervention. Future studies should determine the incidence of bile acid biosynthetic and transport defects in patients with enigmatic and unexplained liver diseases.
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Affiliation(s)
- W F Balistreri
- Division of Pediatric Gastroenterology, Nutrition, and Liver Transplantation, Children's Hospital Medical Center, Cincinnati, Ohio, USA
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7
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Youssef JA, Song WO, Badr MZ. Mitochondrial, but not peroxisomal, beta-oxidation of fatty acids is conserved in coenzyme A-deficient rat liver. Mol Cell Biochem 1997; 175:37-42. [PMID: 9350031 DOI: 10.1023/a:1006877021617] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hepatic coenzyme A (CoA) plays an important role in cellular lipid metabolism. Because mitochondria and peroxisomes represent the two major subcellular sites of lipid metabolism, the present study was designed to investigate the specific impact of hepatic CoA deficiency on peroxisomal as well as mitochondrial beta-oxidation of fatty acids. CoA deficiency (47% decrease in free CoA and 23% decrease in total CoA) was produced by maintaining weanling male Sprague-Dawley rats on a semipurified diet deficient in pantothenic acid (the precursor of CoA) for 5 weeks. Hepatic mitochondrial fatty acid oxidation of short-chain and long-chain fatty acids were not significantly different between control and CoA-deficient rats. Conversely, peroxisomal beta-oxidation was significantly diminished (38% inhibition) in livers of CoA-deficient rats compared to control animals. Peroxisomal beta-oxidation was restored to normal levels when hepatic CoA was replenished. It is postulated that since the role of hepatic mitochondrial beta-oxidation is energy production while peroxisomal beta-oxidation acts mainly as a detoxification system, the mitochondrial pathway of beta-oxidation is spared at the expense of the peroxisomal pathway when liver CoA plummets. The present study may offer an animal model to investigate mechanisms involved in peroxisomal diseases.
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Affiliation(s)
- J A Youssef
- Division of Pharmacology, University of Missouri-Kansas City 64108, USA
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8
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Ruiz M, Coll MJ, Pampols T, Girós M. ALDP expression in fetal cells and its application in prenatal diagnosis of X-linked adrenoleukodystrophy. Prenat Diagn 1997. [DOI: 10.1002/(sici)1097-0223(199707)17:7<651::aid-pd131>3.0.co;2-h] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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9
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Affiliation(s)
- H W Moser
- Kennedy Krieger Institute, Johns Hopkins University Baltimore, Maryland 21205, USA
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10
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Abstract
In 1973 Goldfischer et al reported that patients with the Zellweger cerebro-hepato-renal syndrome lacked demonstrable peroxisomes. This was the first time that a human disease state was attributed to a disorder of peroxisomes, subcellular organelles that had received little attention until that time. Interest in the organelle has increased rapidly during the last 10 years, both in respect to its cellular and molecular biology, and also in respect to its role in clinical medicine. Sixteen peroxisomal disorders have been identified at this time. They are pertinent to the neurologist because 12 of these disorders are associated with severe neurological disability. Furthermore, they are not infrequent: our laboratory has identified more than 3,000 patients. This presentation will provide basic information about peroxisome structure and function and then summarize the classification, diagnosis, genetics, pathogenesis, and therapy of the peroxisomal disorders.
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Affiliation(s)
- H W Moser
- Kennedy Krieger Institute, Baltimore, MD 21205, USA
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11
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Abstract
Primary hyperoxaluria type 1 (PH1) is a potentially lethal autosomal recessive disorder of glyoxylate metabolism caused by a deficiency of the liver-specific peroxisomal enzyme alanine:glyoxylate aminotransferase (AGT). Over the past 13 years, various strategies have been adopted for its prenatal diagnosis, including (1) glyoxylate metabolite analysis of amniotic fluid in the second trimester; (2) AGT enzyme assay, immunoassay, and immuno-electron microscopy of fetal liver biopsies also in the second trimester; and (3) linkage and mutation analysis of DNA isolated from chorionic villus samples in the first trimester. These methods have evolved in parallel with our increased understanding of the molecular aetiology and pathogenesis of the disease. Although the usefulness of metabolite analysis remains unproven, all the other methods have been successfully applied to the prenatal diagnosis of PH1. In this review, examples of the use of the available methodologies are provided, and their pros and cons are discussed with reference to specific cases.
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Affiliation(s)
- C J Danpure
- MRC Laboratory for Molecular Cell Biology, University College London, UK
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12
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Barth PG, Wanders RJ, Schutgens RB, Staalman CR. Variant rhizomelic chondrodysplasia punctata (RCDP) with normal plasma phytanic acid: clinico-biochemical delineation of a subtype and complementation studies. AMERICAN JOURNAL OF MEDICAL GENETICS 1996; 62:164-8. [PMID: 8882397 DOI: 10.1002/(sici)1096-8628(19960315)62:2<164::aid-ajmg9>3.0.co;2-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Rhizomelic chondrodysplasia calcificans punctata (RCDP) is an autosomal recessive peroxisomal disorder which affects phytanic acid oxidation and de novo biosynthesis of plasmalogens in liver and fibroblasts. Peroxisomal thiolase is present in its unprocessed precursor form (44 kDa). We studied a mentally retarded 9-year-old girl with cataracts and atypical bone dysplasia. Neurological findings were mild compared to classic RCDP. Plasma phytanic acid was normal. Results of de novo plasmalogen synthesis and phytanic acid oxidation studied in cultured skin fibroblasts were intermediate between normal controls and classic RCDP. Peroxisomal thiolase was present only as the unprocessed 44 kDa protein. Taken together these results suggest that we are dealing with a variant form of RCDP with clinical and biochemical abnormalities much milder as compared to classic RCDP. In order to establish the genetic relationship between our patient and classic RCDP patients complementation studies were carried out. Earlier studies had already shown that fibroblasts from all RCDP patients studied belong to a single complementation group. Fibroblasts from our patient could also be assigned to this complementation group suggesting that the phenotypic variability results from different mutations within the same gene.
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Affiliation(s)
- P G Barth
- Department of Pediatrics, University Hospital Amsterdam, Netherlands
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13
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Wanders RJ, Ofman R, Romeijn GJ, Schutgens RB, Mooijer PA, Dekker C, van den Bosch H. Measurement of dihydroxyacetone-phosphate acyltransferase (DHAPAT) in chorionic villous samples, blood cells and cultured cells. J Inherit Metab Dis 1995; 18 Suppl 1:90-100. [PMID: 9053559 DOI: 10.1007/bf00711432] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Dihydroxyacetone-phosphate acyltransferase (DHAPAT) is a peroxisomal enzyme catalysing the first step in ether-phospholipid biosynthesis. DHAPAT is deficient in cells from patients suffering from a variety of peroxisomal disorders. Accurate measurement of the activity of this enzyme is of great importance, especially since it is a central parameter in the prenatal diagnosis of the disorders of peroxisome biogenesis, rhizomelic chondrodysplasia punctata and DHAPAT-deficiency. We describe a straightforward and accurate assay allowing the activity of DHAPAT to be measured reliably in chorionic villus samples, blood cells, cultured skin fibroblasts, cultured chorionic villus fibroblasts and cultured amniocytes.
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Affiliation(s)
- R J Wanders
- University Hospital Amsterdam, Academic Medical Centre, Department of Pediatrics, The Netherlands
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14
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Sastrowijoto SH, Vandenberghe K, Moerman P, Lauweryns JM, Fryns JP. Prenatal ultrasound diagnosis of rhizomelic chondrodysplasia punctata in a primigravida. Prenat Diagn 1994; 14:770-6. [PMID: 7991519 DOI: 10.1002/pd.1970140821] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Rhizomelic chondrodysplasia punctata (RCDP) is a sublethal autosomal recessive disorder characterized by skeletal dysplasia, microcephaly, mental retardation, congenital cataracts, joint contractures, skin changes, and failure to thrive. Prenatal ultrasound diagnosis has been reported during the second trimester of pregnancy. Prenatal diagnosis is also possible from the first trimester onwards by demonstration of peroxisomal dysfunction in cultured chorionic villous or amniotic fluid cells. In all cases reported hitherto, the prenatal diagnosis was established after the birth of a previous affected child. In contrast to these studies in pregnant multiparous women at risk for RCDP, we report on the first case of prenatal ultrasound diagnosis of RCDP at 19 weeks' gestation in a primigravida. In addition, a complex cardiac malformation associated with hypoplasia of the thymus (DiGeorge anomaly) is described.
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Affiliation(s)
- S H Sastrowijoto
- Department of Pathology, Academic Hospital Maastricht, The Netherlands
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15
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Wanders RJ, Barth PG, Schutgens RB, Tager JM. Clinical and biochemical characteristics of peroxisomal disorders: an update. Eur J Pediatr 1994; 153:S44-8. [PMID: 7957386 DOI: 10.1007/bf02138777] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Peroxisomal disorders represent a recently recognized group of inherited diseases in man, now comprising 14 different disorders. If discussion is restricted to those peroxisomal disorders in which there is neurological involvement (thereby excluding hyperoxaluria and acatalasaemia), results over the least few years have shown that analysis of very-long-chain fatty acids (VLCFAs) is a highly reliable initial test to establish whether or not one is dealing with a peroxisomal disorder. Rhizomelic chondrodysplasia punctata, its recently identified variant form and glutaryl-CoA oxidase deficiency will show no abnormalities and must be identified by other means. Recently we have found a few clinically proven cases of adrenoleukodystrophy showing normal VLCFA in plasma but clearly abnormal values in fibroblasts. This suggests that great care is warranted in interpreting plasma VLCFA analyses. Furthermore, plasma bile acids, phytanic acid, pristanic acid and pipecolic acid should be analysed in any patient with clinical symptoms suggestive for a peroxisomal disorder but normal plasma VLCFAs.
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Affiliation(s)
- R J Wanders
- Department of Pediatrics and Clinical Biochemistry, University Hospital Amsterdam, The Netherlands
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16
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Pryde PG, Bawle E, Brandt F, Romero R, Treadwell MC, Evans MI. Prenatal diagnosis of nonrhizomelic chondrodysplasia punctata (Conradi-Hünermann syndrome). AMERICAN JOURNAL OF MEDICAL GENETICS 1993; 47:426-31. [PMID: 8135294 DOI: 10.1002/ajmg.1320470327] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Chondrodysplasia punctata has been classified into two major types including the rare autosomal recessive "rhizomelic type" and a more common but genetically heterogenous nonrhizomelic type (referred to by some authors as "Conradi-Hünermann (CH) type"). The former is typically lethal, manifesting serious anomalies, and allowing several instances of confident prenatal diagnosis. The latter being milder has more subtle anomalies and prenatal diagnosis has been uncommonly reported (confined to cases diagnosed incidentally by flat-plate X-ray examination of the mother in late third trimester, and a case found by directed ultrasound performed in a Mendelian affected mother). Cases included 1) a young primigravida thought to be affected with Conradi-Hünermann syndrome presented at 16 weeks gestation for prenatal diagnosis and counseling. Ultrasound examination of the fetus detected assymetric limb shortness allowing the presumptive diagnosis of an affected fetus which was confirmed after delivery near term. 2) A normal 38-year-old multipara with unremarkable family history underwent routine fetal ultrasound evaluation at 18 weeks gestation. Disorganization of the spine, premature echogenicity of femoral epipheses, and frontal bossing with depressed nasal bridge were described. Neonatal examination confirmed suspicion of CH. Case 1 demonstrates the importance of solid clinical diagnosis in Mendelian malformation-affected parents for directing prenatal diagnostic efforts. Case 2 represents the first index case of CH diagnosed antenatally by ultrasound. Diagnostic clues which must be considered in establishing these diagnoses are discussed, as are some of the difficulties and limitations in antenatal counseling such cases.
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Affiliation(s)
- P G Pryde
- Department of Obstetrics/Gynecology, Hutzel Hospital/Wayne State University, Detroit, Michigan 48201
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17
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Frederiks WM, Bosch KS, Ankum M, Wanders RJ. Histochemistry of peroxisomal enzyme activities: a tool in the diagnosis of Zellweger syndrome. J Inherit Metab Dis 1993; 16:921-8. [PMID: 7907383 DOI: 10.1007/bf00711506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The localization of the activity of the peroxisomal enzymes D-amino acid oxidase and hydroxyacid oxidase was studied at the light-microscopical level in livers and kidneys of control subjects and patients with Zellweger syndrome, an inherited disease characterized by a lack of intact peroxisomes. D-Amino acid oxidase and hydroxyacid oxidase activities were demonstrated in unfixed cryostat sections with the cerium-diaminobenzidine-cobalt-hydrogen peroxide procedure, in which cerium ions capture hydrogen peroxide, the product of both enzymes. In a second step reaction decomposition of cerium perhydroxide gives rise to a diaminobenzidine polymer complexed with cobalt ions. D-Amino acid oxidase and hydroxyacid oxidase activities were found in peroxisomes of liver parenchymal cells, and only D-amino acid oxidase in peroxisomes of proximal tubular cells of kidneys of control humans. The activities of these enzymes were not detectable in livers and kidneys of Zellweger patients. It is concluded that the cerium-diaminobenzidine-cobalt-hydrogen peroxide procedure enables the demonstration of peroxisomal enzyme activities in human tissues at the light-microscopical level and is an important tool in detecting patients with Zellweger syndrome.
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Affiliation(s)
- W M Frederiks
- Laboratory of Cell Biology and Histology, University of Amsterdam, The Netherlands
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18
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van den Bosch H, Schrakamp G, Hardeman D, Zomer AW, Wanders RJ, Schutgens RB. Ether lipid synthesis and its deficiency in peroxisomal disorders. Biochimie 1993; 75:183-9. [PMID: 8507680 DOI: 10.1016/0300-9084(93)90076-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This paper deals with the discovery of plasmalogen deficiency in the cerebro-hepato-renal (Zellweger) syndrome and discusses how this has led to the development of postnatal and prenatal diagnostic procedures for this and a number of related peroxisomal disorders in man that show a general impairment in the biosynthesis of ether glycerophospholipids. The results have clearly shown an indispensable role for peroxisomes in the total process of ether lipid synthesis as evidenced by a description of the cellular topography of this process. Platelet-activating factor is a bioactive phospholipid in which the glycero-ether linkage is essential for its biological activities. The deficient formation of this lipid mediator can be correlated to the residual amounts of ether phospholipids found in patients with impaired ether lipid production. Evidence is provided to demonstrate that the extent to which cells upon stimulation produce platelet-activating factor and its 1-acyl counterpart is not caused by enzyme selectivities for ether-linked versus ester-linked phospholipid species. Rather, the relative production of these compounds appears to be mainly governed by the relative abundance of ether-linked and ester-linked precursor molecules and the activity of cellular enzymes, such as lysophospholipases, that catabolize the acyl analog of platelet-activating factor through deacylation.
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Affiliation(s)
- H van den Bosch
- Centre for Biomembranes and Lipid Enzymology, Utrecht, Netherlands
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19
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Wanders RJ, Schutgens RB, Barth PG, Tager JM, van den Bosch H. Postnatal diagnosis of peroxisomal disorders: a biochemical approach. Biochimie 1993; 75:269-79. [PMID: 7685190 DOI: 10.1016/0300-9084(93)90087-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In recent years an increasing number of inherited decreases in man has been identified in which there is an impairment of one or more peroxisomal functions. Sofar 15 different peroxisomal disorders have been identified which can be subdivided into three distinct groups depending upon whether there is a generalized (group A), multiple (group B) or single (group C) loss of peroxisomal functions. In this paper we will briefly describe the functions of peroxisomes in man which are of direct relevance for the peroxisomal disorders known up to now. Based upon the biochemical characteristics of the different peroxisomal disorders, we well describe a straightforward approach for the postnatal identification of patients suspected to suffer from a peroxisomal disorder. Furthermore, a detailed analysis of the biochemical procedures which should be used preferably, is given.
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Affiliation(s)
- R J Wanders
- Department of Clinical Biochemistry, University Hospital Amsterdam, Netherlands
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20
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Wanders RJ, Schutgens RB, van den Bosch H, Tager JM, Kleijer WJ. Prenatal diagnosis of inborn errors in peroxisomal beta-oxidation. Prenat Diagn 1991; 11:253-61. [PMID: 1896411 DOI: 10.1002/pd.1970110407] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In recent years, an increasing number of inherited diseases in man have been recognized in which there is an impairment in the peroxisomal beta-oxidation of very-long-chain fatty acids. In general, these disorders are associated with severe neurological and physical abnormalities and death within the first years of life. In this paper we describe our experience with regard to the prenatal diagnosis of a number of different inborn errors of peroxisomal beta-oxidation. Eleven pregnancies at risk were monitored by measuring very-long-chain fatty acid levels as well as very-long-chain fatty acid beta-oxidation in cultured chorionic villous fibroblasts and/or amniotic fluid cells. Five affected fetuses were identified. It is concluded that prenatal diagnosis in this group of diseases can be done reliably using cultured chorionic villous fibroblasts or amniotic fluid cells.
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Affiliation(s)
- R J Wanders
- Department of Pediatrics, University Hospital of Amsterdam, The Netherlands
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Affiliation(s)
- B Winchester
- Department of Clinical Biochemistry, Hospitals for Sick Children, London
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22
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Gray RG, Green A, Schutgens RB, Wanders RJ, Farndon PA, Kennedy CR. Antenatal diagnosis of rhizomelic chondrodysplasia punctata in the second trimester. J Inherit Metab Dis 1990; 13:380-2. [PMID: 2122105 DOI: 10.1007/bf01799400] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R G Gray
- Department of Clinical Chemistry, Children's Hospital, Birmingham, UK
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Abstract
The initial simple bone marrow transplants for genetic immunodeficiency diseases could hardly be rejected by the host, but required matched sibling donors, only available for about 1 in 5 patients. Improved inductions enabled alternative donors from the family or unrelated volunteers to be used. Measurement of the extent of engraftment by donor cell markers or their normal enzymes showed the need for displacement, which aims to obtain 100% donor-type marrow so that the future immune responses of the recipient become those of the donor and tolerant to donor cells or their products. Immunoprophylaxis can prevent residual host immune cells from surviving to impair the graft. The concept of DBMT with immunoprophylaxis has evolved either to replace abnormal host cells or to confer a component transferable from donor cells to deficient host tissues. Within 10 years over 40 previously fatal genetic diseases have been satisfactorily corrected and seven partially corrected, but for five there has been inadequate delivery of component to genetically defective tissues such as heart, cartilage and brain. The principles can be applied to some 40 other genetic diseases for which no suitable alternative treatments yet exist.
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Affiliation(s)
- J R Hobbs
- Westminster Bone Marrow Team, Charing Cross and Westminster Medical School, Westminster Hospital, London, UK
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Wanders RJ, Schelen A, Feller N, Schutgens RB, Stellaard F, Jakobs C, Mitulla B, Seidlitz G. First prenatal diagnosis of acyl-CoA oxidase deficiency. J Inherit Metab Dis 1990; 13:371-4. [PMID: 2122103 DOI: 10.1007/bf01799398] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R J Wanders
- Department of Paediatrics, University Hospital Amsterdam, The Netherlands
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Saudubray JM, Ogier H, Bonnefont JP, Munnich A, Lombes A, Hervé F, Mitchel G, Thé BP, Specola N, Parvy P. Clinical approach to inherited metabolic diseases in the neonatal period: a 20-year survey. J Inherit Metab Dis 1989; 12 Suppl 1:25-41. [PMID: 2509810 DOI: 10.1007/bf01799284] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Every newborn with unexplained neurological deterioration, ketosis, metabolic acidosis or hypoglycaemia should be suspected of having an inherited error of intermediary metabolism. Many of these conditions can be diagnosed clinically with the aid of simple laboratory investigations. Since a substantial number of these diseases respond well to treatment but may otherwise be fatal, and in order to assure adequate prenatal diagnosis in subsequent pregnancies, a high index of suspicion and rapid diagnosis are necessary in the face of the clinical presentations described. According to three major clinical presentations observed in 218 neonates with inborn errors of intermediary metabolism (neurological distress 'intoxication' type, neurological distress 'energy-deficiency' type and hypoglycaemia with liver dysfunction) and according to the proper use of few laboratory investigations, we propose a method of diagnosis which groups these children into five categories. Initial therapy, and sophisticated investigations can be planned on the basis of this grouping.
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Affiliation(s)
- J M Saudubray
- Département de Pédiatrie, Clinique et Unité de Recherches de génétique Médicale, INSERM U-12, Paris, France
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