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Aspragkathou DD, Spilioti MG, Gkampeta A, Dalpa E, Holeva V, Papadopoulou MT, Serdari A, Dafoulis V, Zafeiriou DI, Evangeliou AE. Branched-chain amino acids as adjunctive-alternative treatment in patients with autism: a pilot study. Br J Nutr 2024; 131:73-81. [PMID: 37424284 DOI: 10.1017/s0007114523001496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The branched-chain amino acid (BCAA) is a group of essential amino acids that are involved in maintaining the energy balance of a human being as well as the homoeostasis of GABAergic, glutamatergic, serotonergic and dopaminergic systems. Disruption of these systems has been associated with the pathophysiology of autism while low levels of these amino acids have been discovered in patients with autism. A pilot open-label, prospective, follow-up study of the use of BCAA in children with autistic behaviour was carried out. Fifty-five children between the ages of 6 and 18 participated in the study from May 2015 to May 2018. We used a carbohydrate-free BCAA-powdered mixture containing 45·5 g of leucine, 30 g of isoleucine and 24·5 g of valine in a daily dose of 0·4 g/kg of body weight which was administered every morning. Following the initiation of BCAA administration, children were submitted to a monthly psychological examination. Beyond the 4-week mark, BCAA were given to thirty-two people (58·18 %). Six of them (10·9 %) discontinued after 4-10 weeks owing to lack of improvement. The remaining twenty-six children (47·27 %) who took BCAA for longer than 10 weeks displayed improved social behaviour and interactions, as well as improvements in their speech, cooperation, stereotypy and, principally, their hyperactivity. There were no adverse reactions reported during the course of the treatment. Although these data are preliminary, there is some evidence that BCAA could be used as adjunctive treatment to conventional therapeutic methods for the management of autism.
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Affiliation(s)
- Despoina D Aspragkathou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Martha G Spilioti
- Department of Neurology, Aristotle University of Thessaloniki, Medical School, AHEPA Hospital, Thessaloniki, Greece
| | - Anastasia Gkampeta
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Efterpi Dalpa
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Vasiliki Holeva
- Psychiatric Clinic, Papageorgiou Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Maria T Papadopoulou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Aspasia Serdari
- Psychiatric Clinic, University Hospital of Alexandroupolis, Thrace University, Medical School, Alexandroupolis, Greece
| | - Vaios Dafoulis
- Psychiatric Clinic of the Hippokration Hospital, Thessaloniki, Greece
| | - Dimitrios I Zafeiriou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Hippokration Hospital, Thessaloniki, Greece
| | - Athanasios E Evangeliou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
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Stone M, Clayton ZS, Buono MJ, Kern M. Exercise intensity influences plasma and sweat amino acid concentrations: a crossover trial. J Sports Med Phys Fitness 2021; 62:525-530. [PMID: 33687176 DOI: 10.23736/s0022-4707.21.12134-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to explore the relationship between concentrations of amino acid (AA) and related metabolites in plasma and sweat obtained before and after exercise performed at different intensities and therefore different rates of sweat loss. METHODS Ten subjects completed a maximally ramped exercise test and three 30-min submaximal (45/60/75% VO2max) exercise bouts. Blood samples were collected before/after the exercise bouts and sweat was collected from the forearm throughout. Samples were analyzed for concentrations of AA and related molecules. RESULTS Sweat AA excretion rate was higher during the 60% bout compared to the 45% bout but was similar in comparison to the 75% indicating a plateau in rates of sweat AA losses as sweat rate increased. Plasma concentrations of AAs, urea, ammonia, and other non-proteinogenic AAs were not significantly different between exercise bouts performed at 45 and 60%. Exercise at 75% tended to reduce concentrations of sweat amino acids with significantly depressed concentrations of glycine, lysine, serine, threonine, histidine, arginine, tryptophan, aspartate and ornithine. CONCLUSIONS Overall, this research suggests that increasing exercise intensity increases AA metabolism as demonstrated by reduced plasma AA concentrations and increased excretion through sweat glands, which is mediated by a mechanism yet to be identified.
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Affiliation(s)
- Michael Stone
- Department of Exercise and Nutritional Science, San Diego State University, San Diego, CA, USA
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Michael J Buono
- Department of Exercise and Nutritional Science, San Diego State University, San Diego, CA, USA
| | - Mark Kern
- Department of Exercise and Nutritional Science, San Diego State University, San Diego, CA, USA -
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Mohammadigheisar M, Shouldice VL, Sands JS, Lepp D, Diarra MS, Kiarie EG. Growth performance, breast yield, gastrointestinal ecology and plasma biochemical profile in broiler chickens fed multiple doses of a blend of red, brown and green seaweeds. Br Poult Sci 2020; 61:590-598. [PMID: 32508147 DOI: 10.1080/00071668.2020.1774512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
1. A total of 864 d old (male) Ross × Ross 708 broiler chicks were allocated to 48 floor pens (12 pens/treatment and 18 birds/pen) to investigate dose-response of a blend of seaweeds (SB) on growth performance, breast yield, jejunal histomorphology, microbial metabolites and community and plasma biochemical profile. 2. A maize-soybean meal diet was formulated with 0, 5, 10 or 20 g/kg of SB. Diets were formulated for a three-phase feeding programme (starter: d 0-10, grower: d 11-24, and finisher: d 25-42) and met or exceeded Aviagen nutrient specifications. Diets were allocated to pens (n = 12) balanced for body weight (BW). Birds had free access to feed and water, BW and feed intake (FI) were monitored by phase. One bird per pen was randomly selected on d 42, bled for plasma, and samples for intestinal tissue and caecal digesta were taken. Microbial DNA was extracted and submitted for microbial community profile using the Illumina Miseq® platform. 3. In the starter phase, SB linearly (P ≤ 0.01) improved BW, body weight gain (BWG), and FCR. However, the improvement was quadratic, such that there was no further improvement beyond 5 g/kg SB inclusion. Growth performance response to SB in the grower phase was similar to the starter phase, with the exception of FCR (P > 0.05). Overall, from d 0-42, a linear and quadratic (P < 0.01) response was observed for final BW (d 42), whereby birds fed 5, 10 and 20 g/kg SB were heavier than control by 166, 183 and 180 g, respectively. A quadratic (P = 0.03) effect was observed for breast yield in response to SB. There was a quadratic reduction (P < 0.05) in gamma-glutamyl transferase (GGT) and a linear increase in glutamate dehydrogenase (GDH) in response to SB. Supplemental SB linearly reduced (P ≤ 0.04) the relative abundance of phylum Bacteroidetes and Proteobacteria, and increased the abundance of phylum Firmicutes (linearly; P = 0.02) and Actinobacteria (quadratically; P = 0.03). 4. The data indicated that the optimal inclusion for SB was between 5 and 10 g/kg for improved growth performance and breast yield. However, increased abundance of Firmicutes and actinobacteria in the caecal digesta suggested that the higher doses enhanced prebiotic effects of seaweed components.
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Affiliation(s)
- M Mohammadigheisar
- Department of Animal Biosciences, University of Guelph , Guelph, ON, Canada
| | - V L Shouldice
- Department of Animal Biosciences, University of Guelph , Guelph, ON, Canada
| | - J S Sands
- Ocean Harvest Technology, Technical Services , Milltown, Ireland
| | - D Lepp
- Guelph Research and Development Centre, Agriculture and Agri-Food Canada , Guelph, ON, Canada
| | - M S Diarra
- Guelph Research and Development Centre, Agriculture and Agri-Food Canada , Guelph, ON, Canada
| | - E G Kiarie
- Department of Animal Biosciences, University of Guelph , Guelph, ON, Canada
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Hertig D, Felser A, Diserens G, Kurth S, Vermathen P, Nuoffer JM. Selective galactose culture condition reveals distinct metabolic signatures in pyruvate dehydrogenase and complex I deficient human skin fibroblasts. Metabolomics 2019; 15:32. [PMID: 30830487 DOI: 10.1007/s11306-019-1497-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/21/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION A decline in mitochondrial function represents a key factor of a large number of inborn errors of metabolism, which lead to an extremely heterogeneous group of disorders. OBJECTIVES To gain insight into the biochemical consequences of mitochondrial dysfunction, we performed a metabolic profiling study in human skin fibroblasts using galactose stress medium, which forces cells to rely on mitochondrial metabolism. METHODS Fibroblasts from controls, complex I and pyruvate dehydrogenase (PDH) deficient patients were grown under glucose or galactose culture condition. We investigated extracellular flux using Seahorse XF24 cell analyzer and assessed metabolome fingerprints using NMR spectroscopy. RESULTS Incubation of fibroblasts in galactose leads to an increase in oxygen consumption and decrease in extracellular acidification rate, confirming adaptation to a more aerobic metabolism. NMR allowed rapid profiling of 41 intracellular metabolites and revealed clear separation of mitochondrial defects from controls under galactose using partial least squares discriminant analysis. We found changes in classical markers of mitochondrial metabolic dysfunction, as well as unexpected markers of amino acid and choline metabolism. PDH deficient cell lines showed distinct upregulation of glutaminolytic metabolism and accumulation of branched-chain amino acids, while complex I deficient cell lines were characterized by increased levels in choline metabolites under galactose. CONCLUSION Our results show the relevance of selective culture methods in discriminating normal from metabolic deficient cells. The study indicates that untargeted fingerprinting NMR profiles provide physiological insight on metabolic adaptations and can be used to distinguish cellular metabolic adaptations in PDH and complex I deficient fibroblasts.
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Affiliation(s)
- Damian Hertig
- Departments of BioMedical Research and Radiology, University of Bern, Bern, Switzerland
- Institute of Clinical Chemistry, Inselspital, University Hospital Bern, 3010, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Andrea Felser
- Institute of Clinical Chemistry, Inselspital, University Hospital Bern, 3010, Bern, Switzerland
| | - Gaëlle Diserens
- Departments of BioMedical Research and Radiology, University of Bern, Bern, Switzerland
| | - Sandra Kurth
- Institute of Clinical Chemistry, Inselspital, University Hospital Bern, 3010, Bern, Switzerland
| | - Peter Vermathen
- Departments of BioMedical Research and Radiology, University of Bern, Bern, Switzerland
| | - Jean-Marc Nuoffer
- Institute of Clinical Chemistry, Inselspital, University Hospital Bern, 3010, Bern, Switzerland.
- Department of Paediatrics, Inselspital, University Hospital Bern, Bern, Switzerland.
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Direct Sensing of Nutrients via a LAT1-like Transporter in Drosophila Insulin-Producing Cells. Cell Rep 2017; 17:137-148. [PMID: 27681427 PMCID: PMC5055474 DOI: 10.1016/j.celrep.2016.08.093] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/28/2016] [Accepted: 08/29/2016] [Indexed: 12/22/2022] Open
Abstract
Dietary leucine has been suspected to play an important role in insulin release, a hormone that controls satiety and metabolism. The mechanism by which insulin-producing cells (IPCs) sense leucine and regulate insulin secretion is still poorly understood. In Drosophila, insulin-like peptides (DILP2 and DILP5) are produced by brain IPCs and are released in the hemolymph after leucine ingestion. Using Ca2+-imaging and ex vivo cultured larval brains, we demonstrate that IPCs can directly sense extracellular leucine levels via minidiscs (MND), a leucine transporter. MND knockdown in IPCs abolished leucine-dependent changes, including loss of DILP2 and DILP5 in IPC bodies, consistent with the idea that MND is necessary for leucine-dependent DILP release. This, in turn, leads to a strong increase in hemolymph sugar levels and reduced growth. GDH knockdown in IPCs also reduced leucine-dependent DILP release, suggesting that nutrient sensing is coupled to the glutamate dehydrogenase pathway. IPCs directly sense extracellular leucine levels via minidiscs (MND) MND knockdown in IPCs abolishes loss of DILP2 and DILP5 This leads to a strong increase in hemolymph sugar levels and reduces growth GDH knockdown in IPCs reduces leucine-dependent DILP release
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Branched-chain amino acids ameliorate fibrosis and suppress tumor growth in a rat model of hepatocellular carcinoma with liver cirrhosis. PLoS One 2013; 8:e77899. [PMID: 24223741 PMCID: PMC3815299 DOI: 10.1371/journal.pone.0077899] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 09/14/2013] [Indexed: 12/22/2022] Open
Abstract
Purpose Recent studies have revealed that branched-chain amino acids (BCAA) reduce the development of hepatocellular carcinoma (HCC) in patients with obesity and hepatitis C virus infection by improving insulin resistance (IR). The aim of this study was to examine the anti-cancer and anti-fibrotic effects of BCAA on the development of diethylnitrosamine (DEN)-induced HCC and liver cirrhosis in a rat model. Methods Male SD rats received weekly intraperitoneal injections of DEN (50 mg/kg of body weight) for 16 weeks to induce HCC. They were fed a diet containing 3% casein, 3% or 6% BCAA for 13 weeks beginning 6 weeks after DEN administration. DEN was used to induce HCC through stepwise development from cirrhosis to HCC. The effect of BCAA was evaluated in tumor tissues by histopathologic analyses, reverse transcription-polymerase chain reaction, and Western blotting. Results The mean area and number of dysplastic nodules (DNs) and tumors in the casein group tended to be larger than those in the BCAA group 16 weeks after DEN administration. The mean fibrotic area in the BCAA group was smaller than that in the casein group. The BCAA group showed decreased mRNA levels for markers of fibrosis, angiogenesis, and apoptosis inhibition. Compared with the casein group, the BCAA group had lower levels of α-smooth muscle actin, vascular endothelial growth factor, p-β-catenin, p-p38 mitogen-activated protein kinase, proliferating cell nuclear antigen, and caspase-3 protein expression, as well as a higher level of cleaved caspase-3 protein expression. Conclusions BCAA supplementation of the diet ameliorated liver fibrosis and HCC development in a DEN-induced rat model of HCC with liver cirrhosis, but not in the IR model. These results provide a rationale for anti-fibrosis and chemoprevention using BCAA treatment for HCC with liver cirrhosis, as well as decreasing the ammonia level.
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Kobayashi H, Eguchi A, Takano W, Shibata M, Kadowaki M, Fujimura S. Regulation of muscular glutamate metabolism by high-protein diet in broiler chicks. Anim Sci J 2010; 82:86-92. [PMID: 21269365 DOI: 10.1111/j.1740-0929.2010.00811.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The major taste active component, glutamate (Glu), improves the taste of meat. In this study, we investigated the effect of a short-term high-protein (HCP) diet on the intramuscular free Glu content to improve the taste of meat. Furthermore, we elucidated how the muscle free Glu content was controlled by the HCP diet. Chicks (14 days old) were fed the control diet or HCP diet for 10 days. Plasma and muscle free amino acid concentrations, and activity and messenger RNA (mRNA) expression of muscle enzymes related to Glu metabolism were determined. Muscle free Glu content was increased (P < 0.01) by 51%. Activity and mRNA expression of glutaminase (GA), which is one of the major Glu-related enzymes, were significantly decreased (P < 0.05) in the HCP group because of feedback inhibition. The mRNA expression of lysine α-ketoglutarate reductase (LKR), which is the enzyme involved in lysine (Lys) degradation and Glu production, was significantly increased (P < 0.001) in the HCP group. These results suggest that short-term dietary HCP feeding is an effective treatment for improving the taste of meat. Furthermore, our results suggest that the free Glu content in muscle is regulated by GA and LKR.
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Affiliation(s)
- Hiroyuki Kobayashi
- Graduate School of Science and Technology, Niigata University, Niigata, Japan
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8
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Imanari M, Kadowaki M, Fujimura S. Regulation of taste-active components of meat by dietary branched-chain amino acids; effects of branched-chain amino acid antagonism. Br Poult Sci 2008; 49:299-307. [DOI: 10.1080/00071660802155080] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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9
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Imanari M, Kadowaki M, Fujimura S. Regulation of taste-active components of meat by dietary leucine. Br Poult Sci 2007; 48:167-76. [PMID: 17453808 DOI: 10.1080/00071660701244738] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
1. Regulation of meat taste is one effective method for improvement of meat quality. In this study, effects of dietary leucine (Leu) content on taste-active components, especially free glutamate (Glu), in meat were investigated. 2. Broiler chickens (28 d old) were fed on diets with graded dietary Leu content (100, 130 or 150% of Leu requirement in NRC, 1994) for 10 d before marketing. Taste-active components of meat (free amino acids and ATP metabolites) and sensory score of meat soup were estimated. 3. Free Glu content, the main taste-active component of meat, was significantly increased by dietary Leu. Compared with the Leu 130% group, free Glu was increased by 17% in the Leu 100% group. Free Glu of meat tended to decrease in the Leu 150% group. In contrast, inosine monophosphate content in meat did not change among all groups. 4. Sensory evaluation of meat soup from the Leu 100 and 150% groups showed that they had different meat tastes. Sensory scores of overall preference, umami taste and chicken-like taste were significantly higher in the Leu 100% group. 5. These results suggest that dietary Leu content is a regulating factor of free Glu in meat. Decreasing dietary Leu induces an increase in the free Glu content of meat and improves meat taste.
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Affiliation(s)
- M Imanari
- Graduate School of Science and Technology, Niigata University, Niigata, Japan
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Araújo P, Wassermann GF, Tallini K, Furlanetto V, Vargas CR, Wannmacher CM, Dutra-Filho CS, Wyse AT, Wajner M. Reduction of large neutral amino acid levels in plasma and brain of hyperleucinemic rats. Neurochem Int 2001; 38:529-37. [PMID: 11248401 DOI: 10.1016/s0197-0186(00)00100-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Neurological dysfunction is common in patients with maple syrup urine disease (MSUD). However, the mechanisms underlying the neuropathology of this disorder are poorly known. In the present study we investigated the effect of acute hyperleucinemia on plasma and brain concentrations of amino acids. Fifteen-day-old rats were injected subcutaneously with 6 micromol L-leucine per gram body weight. Controls received saline in the same volumes. The animals were sacrificed 30--120 min after injection, blood was collected and their brain rapidly removed and homogenized. The amino acid concentrations were determined by HPLC using orthophtaldialdehyde for derivatization and fluorescence for detection. The results showed significant reductions of the large neutral amino acids (LNAA) L-phenylalanine, L-tyrosine, L-isoleucine, L-valine and L-methionine, as well as L-alanine, L-serine and L-histidine in plasma and of L-phenylalanine, L-isoleucine, L-valine and L-methionine in brain, as compared to controls. In vitro experiments using brain slices to study the influence of leucine on amino acid transport and protein synthesis were also carried out. L-Leucine strongly inhibited [14C]-L-phenylalanine transport into brain, as well as the incorporation of the [14C]-amino acid mixture, [14C]-L-phenylalanine and [14C]-L-lysine into the brain proteins. Although additional studies are necessary to evaluate the importance of these effects for MSUD, considering previous findings of reduced levels of LNAA in plasma and CSF of MSUD patients during crises, it may be speculated that a decrease of essential amino acids in brain may lead to reduction of protein and neurotransmiter synthesis in this disorder.
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Affiliation(s)
- P Araújo
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600, CEP 90.035-003, Porto Alegre, RS, Brazil
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Wajner M, Coelho DM, Barschak AG, Araújo PR, Pires RF, Lulhier FL, Vargas CR. Reduction of large neutral amino acid concentrations in plasma and CSF of patients with maple syrup urine disease during crises. J Inherit Metab Dis 2000; 23:505-12. [PMID: 10947205 DOI: 10.1023/a:1005668431926] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Neurological dysfunction is common in patients with maple syrup urine disease (MSUD). However, the mechanisms underlying the neuropathology of this disorder are poorly understood. We determined the concentrations of all amino acids in plasma of patients with MSUD during crises (with severe CNS symptoms) and after recovery in the hope of detecting possible alterations of these levels during metabolic decompensation. Blood samples obtained from 11 children with MSUD aged 1 month to 7 years and from 10 age-matched controls (5 months to 6 years) with no evidence of metabolic disease were examined for their amino acid content by high-performance liquid chromatography. We observed that leucine, isoleucine and valine concentrations were respectively 30, 9 and 3 times higher than normal values, whereas the concentrations of the large neutral amino acids (LNAA) phenylalanine, tyrosine, tryptophan and methionine were significantly lower during metabolic decompensation as compared to the controls. In addition, concentrations of leucine, but not of valine or isoleucine, were inversely related to the LNAA concentrations in plasma. The concentrations of these amino acids in plasma returned to normal values when patients were clinically well. CSF amino acid concentrations also showed decreased amounts of LNAA and increased concentrations of branched-chain amino acids. It is possible that the decrease in plasma concentrations of LNAA may lead to a deficit of these essential amino acids in the brain as well as of their products such as proteins and neurotransmitters, a fact that might be related to the neurological dysfunction of MSUD.
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Affiliation(s)
- M Wajner
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil.
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Abstract
The branched-chain amino acids (BCAA), isoleucine, leucine and valine, are unique in that they are principally metabolized extrahepatically in the skeletal muscle. This observation led to the investigation of these nutrients in a number of clinical scenarios. By far the most intensively studied applications for BCAA have been in patients with liver failure and/or patients in catabolic disease states. However, the resulting studies have not demonstrated a clear clinical benefit for BCAA nutritional supplements. In patients with liver failure, the BCAA did improve nitrogen retention and protein synthesis, but their effect on patient outcome was less clear. Similarly, in critically ill septic patients, BCAA did not improve either survival or morbidity. The BCAA are important nutrients, and it seems that any specific benefits associated with their use will be based upon a greater understanding of the underlying cellular biology. Potential areas of further research may include the combination of BCAA supplements with other anabolic factors (e.g. growth hormone) in managing patients with catabolic disease states.
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Affiliation(s)
- C Platell
- University Department of Surgery at Fremantle Hospital, Perth, Western Australia, Australia
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