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Raveendran A, Gupta A, Lewis LE, Prabhu K, Moorkoth S. A comprehensive approach for detection of biotin deficiency from dried blood spot samples using liquid chromatography-mass spectrometry. Future Sci OA 2024; 10:2355038. [PMID: 38963009 PMCID: PMC11229587 DOI: 10.1080/20565623.2024.2355038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/24/2024] [Indexed: 07/05/2024] Open
Abstract
Aim: The aim of the present study is to develop a liquid chromatography-mass spectrometry method to measure two important biomarkers of biotin deficiency from dried blood spot samples for effective management of the disorder. Materials & methods: The method was developed on a liquid chromatography-mass spectrometry system using pentafluorophenyl column employing a mobile phase composition of methanol and water in the isocratic mode. A full validation of the method was performed as per relevant guidelines. Results & conclusion: Correlation between the results of dried blood spot and plasma method was evaluated to determine the interconvertibility of the method. The developed method was successfully applied for establishing the reference ranges for these biomarkers in the population of Udupi, a coastal district of South India.
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Affiliation(s)
- Arya Raveendran
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Ashutosh Gupta
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Leslie E Lewis
- Department of Pediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Krishnananda Prabhu
- Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Sudheer Moorkoth
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
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2
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Latzer IT, Blau N, Ferreira CR, Pearl PL. Clinical and biochemical footprints of inherited metabolic diseases. XV. Epilepsies. Mol Genet Metab 2023; 140:107690. [PMID: 37659319 DOI: 10.1016/j.ymgme.2023.107690] [Citation(s) in RCA: 1] [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: 06/11/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/04/2023]
Abstract
We provide a comprehensive overview of inherited metabolic disorders (IMDs) in which epilepsy is a prominent manifestation. Our unique database search has identified 256 IMDs associated with various types of epilepsies, which we classified according to the classic pathophysiology-based classification of IMDs, and according to selected seizure-related factors (neonatal seizures, infantile spasms, myoclonic seizures, and characteristic EEG patterns) and treatability for the underlying metabolic defect. Our findings indicate that inherited metabolic epilepsies are more likely to present in the neonatal period, with infantile spasms or myoclonic seizures. Additionally, the ∼20% of treatable inherited metabolic epilepsies found by our search were mainly associated with the IMD groups of "cofactor and mineral metabolism" and "Intermediary nutrient metabolism." The information provided by this study, including a comprehensive list of IMDs with epilepsy stratified according to age of onset, and seizure type and characteristics, along with an overview of the key clinical features and proposed diagnostic and therapeutic approaches, may benefit any epileptologist and healthcare provider caring for individuals with metabolic conditions.
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Nenad Blau
- Division of Metabolism, University Children's Hospital, Zürich, Switzerland.
| | - Carlos R Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Phillip L Pearl
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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3
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Ramirez EL, Gibson JB, Jülich K. Vitamin-Dependent Genetic Disorders of Childhood. Pediatr Rev 2023; 44:618-631. [PMID: 37907415 DOI: 10.1542/pir.2022-005637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
| | - James B Gibson
- Department of Pediatrics, The University of Texas at Austin, Dell Medical School, Austin, TX
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Bianciardi S, Tesi G, Cerutti H, Cartocci A, Guerranti R, Silvestrini C, Gori S, Bandini T, Brogi A, Leoncini R. Validation, performance, and reliability of two automated tests for vitamin B12 and folate assay. J Public Health Res 2023; 12:22799036231217803. [PMID: 38108046 PMCID: PMC10722937 DOI: 10.1177/22799036231217803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background Deficiency of Vitamin B12 and folate may determine hematological, neurological, and metabolic alterations; therefore, an accurate quantification of their serum levels is required, especially in the presence of symptoms that might suggest a deficiency. CHORUS VIT B12 and CHORUS FOLATE are two automated immunoassays, developed to quantify vitamin B12 and folate, respectively, in human serum. Design and methods This single-center, non-pharmacological, diagnostic study described the validation and characterization of CHORUS VIT B12 and CHORUS FOLATE, with a specific focus on performance, precision, and reliability. For each assay, 500 serum samples were analyzed. A comparison between CHORUS assays and commercially available kit was also performed. Results For CHORUS VIT B12 the lower limit of quantification (LLoQ) was 165.0 pg/mL and the upper LoQ (ULoQ) was 1846.8 pg/mL. The assay was linear within the calibration range (150-2000 pg/mL) and the accuracy was described with the International Standard Vitamin B12, Serum Folate, HOLO TC (NIBSC code: 03/178), with a mean recovery on two lots of 111%. For CHORUS FOLATE (calibration range of 2.0-20.0 ng/mL), LLoQ was 2.0 ng/mL and ULoQ 19.6 ng/mL. The linearity was demonstrated from 2.4 to 20.0 ng/mL; the accuracy was described with the International Standard mentioned above, achieving a mean recovery on three lots of 92%. The lowest and highest values of both CHORUS and COBAS kits were similar and the median values did not significantly vary. Conclusion CHORUS VIT B12 and CHORUS FOLATE performed well, accurately, and reliably in quantifying vitamin B12 and folate in human serum.
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Affiliation(s)
- Simone Bianciardi
- DIESSE Diagnostica Senese S.p.A. Società Benefit, Monteriggioni, Siena, Italy
| | - Giulia Tesi
- DIESSE Diagnostica Senese S.p.A. Società Benefit, Monteriggioni, Siena, Italy
| | - Helena Cerutti
- DIESSE Diagnostica Senese S.p.A. Società Benefit, Monteriggioni, Siena, Italy
| | | | - Roberto Guerranti
- Laboratorio Patologia Clinica, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Caterina Silvestrini
- Laboratorio Patologia Clinica, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Sabrina Gori
- Laboratorio Patologia Clinica, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Tommaso Bandini
- DIESSE Diagnostica Senese S.p.A. Società Benefit, Monteriggioni, Siena, Italy
| | - Alessandra Brogi
- DIESSE Diagnostica Senese S.p.A. Società Benefit, Monteriggioni, Siena, Italy
| | - Roberto Leoncini
- Laboratorio Patologia Clinica, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
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5
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Fukunaga T, Ohta R, Sano C. The Association Between Vitamin B1 Deficiency and Anemia Among Elderly Patients at a Rural Hospital in Japan: A Cross-Sectional Study. Cureus 2023; 15:e47173. [PMID: 38021762 PMCID: PMC10652054 DOI: 10.7759/cureus.47173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objective Vitamin B1 deficiency can cause a variety of abnormalities in the neuropsychiatric, cardiovascular, and other systems. This condition can be rapidly corrected and prevented from progressing to irreversible sequelae through vitamin B1 supplementation. Therefore, early detection of and intervention in vitamin B1 deficiency are essential. We have previously demonstrated an association between vitamin B1 deficiency and appetite loss in hospitalized older adult patients in rural Japan. This study aimed to examine the additional predictors of vitamin B1 deficiency in patients with appetite loss and other symptoms suggestive of vitamin B1 deficiency. Material and methods This cross-sectional study involved 519 patients admitted to a rural hospital between April 2020 and March 2022. Data on vitamin B1 levels, age, sex, BMI, albumin levels, functional independence measure (FIM), hemoglobin levels, Charlson Comorbidity Index (CCI), and medications were collected from electronic medical records. Vitamin B1 deficiency was defined as serum vitamin B1 level <20 µg/dL. Data were analyzed using the Mann-Whitney U test, Student's t-test, and chi-square test, followed by multivariate logistic regression to examine the predictors of vitamin B1 deficiency. Results A total of 113 patients (21.5%) were found to be vitamin B1-deficient. Multivariate logistic regression showed that anemia was significantly associated with vitamin B1 deficiency [adjusted odds ratio (AOR): 1.71, 95% confidence interval (CI): 1.07-2.73, p<0.05]. Conclusion Based on our findings, anemia is significantly associated with vitamin B1 deficiency in hospitalized Japanese patients living in rural areas. Therefore, physicians should be mindful of the possibility of vitamin B1 deficiency in hospitalized patients with anemia.
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Affiliation(s)
- Toshiki Fukunaga
- Family Medicine, Community Medicine Management, Faculty of Medicine, Shimane University, Izumo, JPN
| | | | - Chiaki Sano
- Medicine, Community Medicine Management, Faculty of Medicine, Shimane University, Izumo, JPN
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Bremova-Ertl T, Hofmann J, Stucki J, Vossenkaul A, Gautschi M. Inborn Errors of Metabolism with Ataxia: Current and Future Treatment Options. Cells 2023; 12:2314. [PMID: 37759536 PMCID: PMC10527548 DOI: 10.3390/cells12182314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
A number of hereditary ataxias are caused by inborn errors of metabolism (IEM), most of which are highly heterogeneous in their clinical presentation. Prompt diagnosis is important because disease-specific therapies may be available. In this review, we offer a comprehensive overview of metabolic ataxias summarized by disease, highlighting novel clinical trials and emerging therapies with a particular emphasis on first-in-human gene therapies. We present disease-specific treatments if they exist and review the current evidence for symptomatic treatments of these highly heterogeneous diseases (where cerebellar ataxia is part of their phenotype) that aim to improve the disease burden and enhance quality of life. In general, a multimodal and holistic approach to the treatment of cerebellar ataxia, irrespective of etiology, is necessary to offer the best medical care. Physical therapy and speech and occupational therapy are obligatory. Genetic counseling is essential for making informed decisions about family planning.
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Affiliation(s)
- Tatiana Bremova-Ertl
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland; (J.H.); (J.S.)
- Center for Rare Diseases, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland
| | - Jan Hofmann
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland; (J.H.); (J.S.)
| | - Janine Stucki
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland; (J.H.); (J.S.)
| | - Anja Vossenkaul
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.V.); (M.G.)
| | - Matthias Gautschi
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.V.); (M.G.)
- Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
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Hassan Z, Coelho D, Bossenmeyer-Pourié C, Matmat K, Arnold C, Savladori A, Alberto JM, Umoret R, Guéant JL, Pourié G. Cognitive Impairment Is Associated with AMPAR Glutamatergic Dysfunction in a Mouse Model of Neuronal Methionine Synthase Deficiency. Cells 2023; 12:cells12091267. [PMID: 37174668 PMCID: PMC10177068 DOI: 10.3390/cells12091267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 05/15/2023] Open
Abstract
Impairment of one-carbon metabolism during pregnancy, either due to nutritional deficiencies in B9 or B12 vitamins or caused by specific genetic defects, is often associated with neurological defects, including cognitive dysfunction that persists even after vitamin supplementation. Animal nutritional models do not allow for conclusions regarding the specific brain mechanisms that may be modulated by systemic compensations. Using the Cre-lox system associated to the neuronal promoter Thy1.2, a knock-out model for the methionine synthase specifically in the brain was generated. Our results on the neurobehavioral development of offspring show that the absence of methionine synthase did not lead to growth retardation, despite an effective reduction of both its expression and the methylation status in brain tissues. Behaviors were differently affected according to their functional outcome. Only temporary retardations were recorded in the acquisition of vegetative functions during the suckling period, compared to a dramatic reduction in cognitive performance after weaning. Investigation of the glutamatergic synapses in cognitive areas showed a reduction of AMPA receptors phosphorylation and clustering, indicating an epigenomic effect of the neuronal deficiency of methionine synthase on the reduction of glutamatergic synapses excitability. Altogether, our data indicate that cognitive impairment associated with methionine synthase deficiency may not only result from neurodevelopmental abnormalities, but may also be the consequence of alterations in functional plasticity of the brain.
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Affiliation(s)
- Ziad Hassan
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - David Coelho
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
- National Center of Inborn Errors of Metabolism, University Regional Hospital Center of Nancy, F-54000 Nancy, France
| | - Carine Bossenmeyer-Pourié
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - Karim Matmat
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - Carole Arnold
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - Aurélie Savladori
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - Jean-Marc Alberto
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - Rémy Umoret
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
| | - Jean-Louis Guéant
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
- National Center of Inborn Errors of Metabolism, University Regional Hospital Center of Nancy, F-54000 Nancy, France
| | - Grégory Pourié
- Inserm UMRS 1256 NGERE-Nutrition, Genetics, and Environmental Risk Exposure, University of Lorraine, F-54000 Nancy, France
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Aminnejad B, Roumi Z, Hasanpour Ardekanizadeh N, Vahid F, Gholamalizadeh M, Kalantari N, Ataei A, Doaei S. Association of dietary antioxidant index with body mass index in adolescents. Obes Sci Pract 2023; 9:15-22. [PMID: 36789029 PMCID: PMC9913194 DOI: 10.1002/osp4.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/11/2022] Open
Abstract
Background Dietary antioxidants may decrease body fat through reduction of oxidative stress. This study aimed to examine the association between dietary antioxidant index (DAI) and body mass index (BMI) in adolescent boys. Methods In this cross-sectional study, 593 adolescent boys aged 12-16 years were randomly selected and were divided into two groups of overweight and non-overweight individuals. Data on physical activity and anthropometric measurements were collected. Dietary intake was assessed using 168-item semi quantitative food frequency questionnaire and the DAI score was calculated to measure the antioxidant capacity of the diet. Results The overweight adolescents had higher intake of energy (2490.55 ± 632.49 vs. 2354.33 ± 632.64 kcal/d, p = 0.01), carbohydrate (290.21 ± 71.41 vs. 272.93 ± 79.22 g/d, p = 0.01), fat (111.51 ± 40.76 vs. 104.51 ± 35.56 g/d, p = 0.04), calcium (811.70 ± 283.70 vs. 741.06 ± 251.17 g/d, p = 0.003), and vitamin D (1.41 ± 1.17 vs. 1.18 ± 1.19 μg/d, p = 0.031) in comparison with normal weight adolescents. The DAI had an inverse association with BMI after adjustment for age and caloric intake (OR: 0.85, 95% CI: 0.76-0.96, p = 0.009). Additional adjustment for dietary intake of vitamin A, vitamin E, vitamin C, zinc, manganese, and selenium did not change the results. Conclusion The results of the study showed that following a diet rich in antioxidants may be effective in preventing obesity in adolescent boys. Further longitudinal studies are needed to confirm these finding and to determine the underlying mechanisms.
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Affiliation(s)
- Bahareh Aminnejad
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | - Zahra Roumi
- Master of Science Student of Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | | | - Farhad Vahid
- Population Health DepartmentPublic Health ResearchLuxembourg Institute of HealthStrassenLuxembourg
| | | | - Naser Kalantari
- Department of Community NutritionFaculty of Nutrition and Food TechnologyNational Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
| | - Asal Ataei
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | - Saeid Doaei
- Department of Community NutritionFaculty of Nutrition and Food TechnologyNational Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
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Methner Y, Weber N, Kunz O, Zarnkow M, Rychlik M, Hutzler M, Jacob F. Investigations into metabolic properties and selected nutritional metabolic byproducts of different non-Saccharomyces yeast strains when producing nonalcoholic beer. FEMS Yeast Res 2022; 22:6675809. [PMID: 36007922 PMCID: PMC9629496 DOI: 10.1093/femsyr/foac042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/29/2022] [Accepted: 08/22/2022] [Indexed: 01/07/2023] Open
Abstract
Nonalcoholic beers are becoming increasingly popular, in part due to consumers' awareness of a healthier lifestyle. Additionally, consumers are demanding diversification in the product range, which can be offered by producing nonalcoholic beers using non-Saccharomyces yeasts for fermentation to create a wide variety of flavors. So far, little is known about the nutritionally relevant byproducts that these yeasts release during wort fermentation and whether these yeasts can be considered safe for food fermentations. To gain insights into this, the B vitamins of four different nonalcoholic beers fermented with the yeast species Saccharomycodes ludwigii, Cyberlindnera saturnus (two strains), and Kluyveromyces marxianus were analyzed. Furthermore, a total of 16 beers fermented with different non-Saccharomyces yeast strains were analyzed for biogenic amines. Additionally, stress tolerance tests were performed at 37°C and in synthetic human gastric juice in vitro. B vitamins were found in the four nonalcoholic beers in nutritionally relevant amounts so they could serve as a supplement for a balanced diet. Biogenic amines remained below the limit of determination in all 16 beers, and thus likely had no influence, while the stress tolerance tests gave a first indication that seven yeast strains could possibly tolerate the human gastric juice milieu.
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Affiliation(s)
- Yvonne Methner
- Research Center Weihenstephan for Brewing and Food Quality, Technical University of Munich, Alte Akademie 3, 85354 Freising, Germany
| | - Nadine Weber
- Chair of Analytical Food Chemistry, Technical University of Munich, Maximus-von-Imhof-Forum 2, 85354 Freising, Germany
| | - Oliver Kunz
- Research Center Weihenstephan for Brewing and Food Quality, Technical University of Munich, Alte Akademie 3, 85354 Freising, Germany
| | - Martin Zarnkow
- Research Center Weihenstephan for Brewing and Food Quality, Technical University of Munich, Alte Akademie 3, 85354 Freising, Germany
| | - Michael Rychlik
- Chair of Analytical Food Chemistry, Technical University of Munich, Maximus-von-Imhof-Forum 2, 85354 Freising, Germany,Centre for Nutrition and Food Sciences, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, 306 Carmody Road, St Lucia QLD 4072, Australia
| | - Mathias Hutzler
- Corresponding author: Research Center Weihenstephan for Brewing and Food Quality, Technical University of Munich, Alte Akademie 3, 85354 Freising, Germany. Tel: +49 8161 71-3100; Fax: +49 8161 71-4181; E-mail:
| | - Fritz Jacob
- Research Center Weihenstephan for Brewing and Food Quality, Technical University of Munich, Alte Akademie 3, 85354 Freising, Germany
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Torices L, de las Heras J, Arango-Lasprilla JC, Cortés JM, Nunes-Xavier CE, Pulido R. MMADHC premature termination codons in the pathogenesis of cobalamin D disorder: Potential of translational readthrough reconstitution. Mol Genet Metab Rep 2021; 26:100710. [PMID: 33552904 PMCID: PMC7847965 DOI: 10.1016/j.ymgmr.2021.100710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 11/21/2022] Open
Abstract
Mutations in the MMADHC gene cause cobalamin D disorder (cblD), an autosomal recessive inborn disease with defects in intracellular cobalamin (cbl, vitamin B12) metabolism. CblD patients present methylmalonic aciduria (MMA), homocystinuria (HC), or combined MMA/HC, and usually suffer developmental delay and cognitive deficits. The most frequent MMADHC genetic alterations associated with disease generate MMADHC truncated proteins, in many cases due to mutations that create premature termination codons (PTC). In this study, we have performed a comprehensive and global characterization of MMADHC protein variants generated by all annotated MMADHC PTC mutations in cblD patients, and analyzed the potential of inducible translational PTC readthrough to reconstitute MMADHC biosynthesis. MMADHC protein truncation caused by disease-associated PTC differentially affected the alternative usage of translation initiation sites, protein abundance, and subcellular localization of MMADHC. Aminoglycoside compounds induced translational PTC readthrough of MMADHC truncated variants, allowing the biosynthesis of full-length MMADHC in a PTC-specific manner. Our results suggest that translational PTC readthrough-based interventions could complement current therapies for cblD patients carrying specific MMADHC PTC mutations.
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Affiliation(s)
- Leire Torices
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Javier de las Heras
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Division of Pediatric Metabolism (CIBER-ER), Cruces University Hospital, Barakaldo, Spain
- Department of Pediatrics, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Ikerbasque, The Basque Foundation for Science, 48013 Bilbao, Spain
| | - Jesús M. Cortés
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Ikerbasque, The Basque Foundation for Science, 48013 Bilbao, Spain
| | - Caroline E. Nunes-Xavier
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Institute of Cancer Research, Oslo University Hospital Radiumhospitalet, N-0424 Oslo, Norway
| | - Rafael Pulido
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Ikerbasque, The Basque Foundation for Science, 48013 Bilbao, Spain
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11
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Stieglitz HM, Korpi-Steiner N. Characterization of biotin interference in 21 Vitros 5600 immunoassays and risk mitigation for patient safety at a large academic medical center. Clin Biochem 2019; 75:53-61. [PMID: 31677994 DOI: 10.1016/j.clinbiochem.2019.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Biotin and streptavidin are commonly used reagents in clinical immunoassays. Several cases of biotin interference with immunoassay testing for patients taking biotin supplements have been reported, yet, not all analytes and platforms susceptible to biotin interference have been characterized. The objectives of this study are to characterize biotin interference with 21 immunoassays using the Ortho Clinical Diagnostics Vitros 5600, evaluate a biotin-depletion method, and apply risk mitigation strategies for biotin interference during routine clinical testing at our institution. METHODS Residual serum without and with increasing concentrations of exogenous biotin were used to evaluate biotin interference with 21 immunoassays using the Vitros 5600. Biotin-depletion was evaluated by comparing measured analyte concentrations in serum with and without exogenous biotin and streptavidin-microparticle pretreatment. Focused education for healthcare professionals about biotin interference was performed in February 2018. Samples with suspected biotin interference were investigated using this biotin-depletion method, and analyte testing by alternate methodology for select samples. RESULTS Exogenous biotin in serum caused dose-dependent negative biases in 15 immunometric assays, and dose-dependent positive biases in 6 competitive immunoassays. Streptavidin-microparticle pretreatment of serum containing exogenous biotin demonstrated recoveries 100 ± 15% of expected values for all 21 analytes. Physicians identified 21 samples suspicious for biotin interference over 11 months, and streptavidin-microparticle pretreatment verified 11 cases of biotin interference. CONCLUSIONS Analytical bias caused by biotin interference is dependent on biotin concentration but independent of analyte concentration for immunometric methods using the Vitros 5600, and dependent on both biotin and analyte concentration for competitive immunoassays. Multi-disciplinary education and a lab streptavidin-microparticle pretreatment method help mitigate risk of erroneous results due to biotin interference for patient safety.
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Affiliation(s)
- Heather M Stieglitz
- University of North Carolina, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA
| | - Nichole Korpi-Steiner
- University of North Carolina, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA.
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12
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León-Del-Río A. Biotin in metabolism, gene expression, and human disease. J Inherit Metab Dis 2019; 42:647-654. [PMID: 30746739 DOI: 10.1002/jimd.12073] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 02/05/2019] [Indexed: 12/16/2022]
Abstract
Biotin is a water-soluble vitamin that belongs to the vitamin B complex and which is an essential nutrient of all living organisms from bacteria to man. In eukaryotic cells biotin functions as a prosthetic group of enzymes, collectively known as biotin-dependent carboxylases that catalyze key reactions in gluconeogenesis, fatty acid synthesis, and amino acid catabolism. Enzyme-bound biotin acts as a vector to transfer a carboxyl group between donor and acceptor molecules during carboxylation reactions. In recent years, evidence has mounted that biotin also regulates gene expression through a mechanism beyond its role as a prosthetic group of carboxylases. These activities may offer a mechanistic background to a developing literature on the action of biotin in neurological disorders. This review summarizes the role of biotin in activating carboxylases and proposed mechanisms associated with a role in gene expression and in ameliorating neurological disease.
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Affiliation(s)
- Alfonso León-Del-Río
- Programa de Investigación en Cáncer de Mama and Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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13
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Huemer M, Baumgartner MR. The clinical presentation of cobalamin-related disorders: From acquired deficiencies to inborn errors of absorption and intracellular pathways. J Inherit Metab Dis 2019; 42:686-705. [PMID: 30761552 DOI: 10.1002/jimd.12012] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022]
Abstract
This review gives an overview of clinical characteristics, treatment and outcome of nutritional and acquired cobalamin (Cbl; synonym: vitamin B12) deficiencies, inborn errors of Cbl absorption and intracellular trafficking, as well as methylenetetrahydrofolate dehydrogenase (MTHFD1) and methylene tetrahydrofolate reductase (MTHFR) deficiencies, which impair Cbl-dependent remethylation. Acquired and inborn Cbl-related disorders and MTHFR deficiency cause multisystem, often severe disease. Failure to thrive, neurocognitive or psychiatric symptoms, eye disease, bone marrow alterations, microangiopathy and thromboembolic events are characteristic. The recently identified MTHFD1 defect additionally presents with severe immune deficiency. Deficient Cbl-dependent enzymes cause reduced methylation capacity and metabolite toxicity. Further net-effects of perturbed Cbl function or reduced Cbl supply causing oxidative stress, altered cytokine regulation or immune functions are discussed.
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Affiliation(s)
- Martina Huemer
- Division of Metabolism and Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
- Department of Paediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria
| | - Matthias R Baumgartner
- Division of Metabolism and Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
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14
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de Silva R, Greenfield J, Cook A, Bonney H, Vallortigara J, Hunt B, Giunti P. Guidelines on the diagnosis and management of the progressive ataxias. Orphanet J Rare Dis 2019; 14:51. [PMID: 30786918 PMCID: PMC6381619 DOI: 10.1186/s13023-019-1013-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 01/29/2019] [Indexed: 11/26/2022] Open
Abstract
The progressive ataxias are a group of rare and complicated neurological disorders, knowledge of which is often poor among healthcare professionals (HCPs). The patient support group Ataxia UK, recognising the lack of awareness of this group of conditions, has developed medical guidelines for the diagnosis and management of ataxia. Although ataxia can be a symptom of many common conditions, the focus here is on the progressive ataxias, and include hereditary ataxia (e.g. spinocerebellar ataxia (SCA), Friedreich’s ataxia (FRDA)), idiopathic sporadic cerebellar ataxia, and specific neurodegenerative disorders in which ataxia is the dominant symptom (e.g. cerebellar variant of multiple systems atrophy (MSA-C)). Over 100 different disorders can lead to ataxia, so diagnosis can be challenging. Although there are no disease-modifying treatments for most of these entities, many aspects of the conditions are treatable, and their identification by HCPs is vital. The early diagnosis and management of the (currently) few reversible causes are also of paramount importance. More than 30 UK health professionals with experience in the field contributed to the guidelines, their input reflecting their respective clinical expertise in various aspects of ataxia diagnosis and management. They reviewed the published literature in their fields, and provided summaries on “best” practice, including the grading of evidence available for interventions, using the Guideline International Network (GIN) criteria, in the relevant sections. A Guideline Development Group, consisting of ataxia specialist neurologists and representatives of Ataxia UK (including patients and carers), reviewed all sections, produced recommendations with levels of evidence, and discussed modifications (where necessary) with contributors until consensus was reached. Where no specific published data existed, recommendations were based on data related to similar conditions (e.g. multiple sclerosis) and/or expert opinion. The guidelines aim to assist HCPs when caring for patients with progressive ataxia, indicate evidence-based (where it exists) and best practice, and act overall as a useful resource for clinicians involved in managing ataxic patients. They do, however, also highlight the urgent need to develop effective disease-modifying treatments, and, given the large number of recommendations based on “good practice points”, emphasise the need for further research to provide evidence for effective symptomatic therapies. These guidelines are aimed predominantly at HCPs in secondary care (such as general neurologists, clinical geneticists, physiotherapists, speech and language therapists, occupational therapists, etc.) who provide care for individuals with progressive ataxia and their families, and not ataxia specialists. It is a useful, practical tool to forward to HCPs at the time referrals are made for on-going care, for example in the community.
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Affiliation(s)
- Rajith de Silva
- Department of Neurology, Essex Centre for Neurological Sciences, Queen's Hospital, Romford, RM7 0AG, UK
| | | | - Arron Cook
- Ataxia Centre, Department of Molecular Neurosciences, UCL Queen Sqaure Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | | | | | - Barry Hunt
- Ataxia UK, 12 Broadbent Close, London, N6 5JW, UK
| | - Paola Giunti
- Ataxia Centre, Department of Molecular Neurosciences, UCL Queen Sqaure Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
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15
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Bronsky J, Campoy C, Braegger C. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins. Clin Nutr 2018; 37:2366-2378. [PMID: 30100105 DOI: 10.1016/j.clnu.2018.06.951] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 12/12/2022]
Affiliation(s)
- J Bronsky
- Department of Paediatrics, University Hospital Motol, Prague, Czech Republic.
| | - C Campoy
- Department of Paediatrics, University of Granada, Spain
| | - C Braegger
- Division of Gastroenterology and Nutrition and Children's Research Center, University Children's Hospital Zurich, Switzerland
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16
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Trambas C, Lu Z, Yen T, Sikaris K. Characterization of the scope and magnitude of biotin interference in susceptible Roche Elecsys competitive and sandwich immunoassays. Ann Clin Biochem 2017; 55:205-215. [DOI: 10.1177/0004563217701777] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Biotin interference is a significant problem to which at-risk laboratories must now be attuned. We sought to systematically characterize the nature of this interference in Roche immunoassays. Methods Known concentrations of biotin were titrated into serum samples and the effects on competitive and sandwich immunoassays were analysed. The maximum and minimum concentrations examined reflect those likely to be achieved in individuals on 5 to 10 mg supplements at the lower end, and 100 to 300 mg biotin at the high end. Results A high variability in biotin tolerance was observed. Some assays, such as troponin T, TSH and antithyroid antibodies, were extremely sensitive to the lower concentrations of biotin (15.6 and 31.3 ng/mL), whereas the majority of assays were relatively resistant. At concentrations ≥500 ng/mL, all assays showed significant interference from biotin but, again, the magnitude of the interference was variable. The more sensitive assays showed profound analytical bias at biotin concentrations that occur with high-dose therapy. Conclusion Our data demonstrate high variability in biotin tolerance across Roche immunoassays. The shape of the dose–response curves provides more detailed information than the single manufacturer-quoted figure for biotin tolerance. Accordingly, these data may be used by laboratories for more accurate risk assessment in predicting the effects of biotin. Our data may also be extrapolated to guide timing of blood tests in patients on high-dose biotin therapy: it demonstrates the number of half-lives required to withhold biotin in order to decrease its concentration to below a given assay tolerance.
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Affiliation(s)
| | - Zhong Lu
- Melbourne Pathology, Collingwood, Australia
- Department of Medicine, Monash University, Clayton, Australia
| | - Tina Yen
- Melbourne Pathology, Collingwood, Australia
- Royal Children’s Hospital, Parkville, Australia
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17
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Jinnah HA, Albanese A, Bhatia KP, Cardoso F, Da Prat G, de Koning TJ, Espay AJ, Fung V, Garcia-Ruiz PJ, Gershanik O, Jankovic J, Kaji R, Kotschet K, Marras C, Miyasaki JM, Morgante F, Munchau A, Pal PK, Rodriguez Oroz MC, Rodríguez-Violante M, Schöls L, Stamelou M, Tijssen M, Uribe Roca C, de la Cerda A, Gatto EM. Treatable inherited rare movement disorders. Mov Disord 2017; 33:21-35. [PMID: 28861905 DOI: 10.1002/mds.27140] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/21/2017] [Accepted: 07/23/2017] [Indexed: 12/19/2022] Open
Abstract
There are many rare movement disorders, and new ones are described every year. Because they are not well recognized, they often go undiagnosed for long periods of time. However, early diagnosis is becoming increasingly important. Rapid advances in our understanding of the biological mechanisms responsible for many rare disorders have enabled the development of specific treatments for some of them. Well-known historical examples include Wilson disease and dopa-responsive dystonia, for which specific and highly effective treatments have life-altering effects. In recent years, similarly specific and effective treatments have been developed for more than 30 rare inherited movement disorders. These treatments include specific medications, dietary changes, avoidance or management of certain triggers, enzyme replacement therapy, and others. This list of treatable rare movement disorders is likely to grow during the next few years because a number of additional promising treatments are actively being developed or evaluated in clinical trials. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- H A Jinnah
- Departments of Neurology, Human Genetics and Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Alberto Albanese
- Department of Neurology, Humanitas Research Hospital, Rozzano, Italy.,Catholic University, Milan, Italy
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, London, United Kingdom
| | - Francisco Cardoso
- Department of Internal Medicine, Movement Disorders Clinic, Neurology Service, UFMG, Belo Horizonte, MG, Brazil
| | - Gustavo Da Prat
- Department of Neurology, Affiliated University of Buenos Aires, Buenos Aires, Argentina.,University DelSalvadore, Buenos Aires, Argentina
| | - Tom J de Koning
- Department of Genetics, Pediatrics and Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alberto J Espay
- James J. and Joan A. Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Ohio, USA
| | - Victor Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital & Sydney Medical School, University of Sydney, Sydney, Australia
| | | | - Oscar Gershanik
- Institute of Neuroscience, Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - Joseph Jankovic
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
| | - Ryuji Kaji
- Department of Neurology, Tokushima University Graduate School of Medicine, Tokushima, Japan
| | - Katya Kotschet
- Clinical Neurosciences, St. Vincent's Health, Melbourne, Australia
| | - Connie Marras
- The Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | | | - Francesca Morgante
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alexander Munchau
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neuroscience, Bangalore, India
| | - Maria C Rodriguez Oroz
- University Hospital Donostia, Madrid, Spain.,BioDonostia Research Institute, Basque Center on Cognition, Brain and Language, San Sebastian, Madrid, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | | | - Ludger Schöls
- Department of Neurology and Hertie Institute for Clinical Brain Research, University of Tubingen, Tubingen, Germany.,German Center for Neurodegenerative Diseases, Tubingen, Germany
| | - Maria Stamelou
- Neurology Clinic, Philipps University Marburg, Marburg, Germany.,Parkinson's Disease and Other Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | - Marina Tijssen
- Department of Neurology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Claudia Uribe Roca
- Department of Neurology, British Hospital of Buenos Aires, Buenos Aires, Argentina
| | | | - Emilia M Gatto
- Department of Neurology, Affiliated University of Buenos Aires and University DelSalvadore, Buenos Aires, Argentina
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18
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Abstract
Vitamins and minerals have essential functions in the body, from signal transduction to acting as cofactors for numerous enzymatic processes. Nutritional deficiencies and excess of certain vitamins and minerals can have profound effects on the central and peripheral nervous systems from early development into adulthood. This article summarizes the role of various nutritional factors in the nervous system and the neurological symptoms that can arise from deficiency or excess.
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Affiliation(s)
- Aparna Polavarapu
- From the Section of Neurology, St. Christopher's Hospital for Children, Department of Pediatrics, Drexel University College of Medicine, Phiadelphia, PA
| | - Daphne Hasbani
- From the Section of Neurology, St. Christopher's Hospital for Children, Department of Pediatrics, Drexel University College of Medicine, Phiadelphia, PA.
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19
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Affiliation(s)
| | - Derik Hermsen
- Heinrich Heine University Hospital, Duesseldorf, Germany
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20
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Alegria-Lertxundi I, Alvarez M, Rocandio AM, de Pancorbo MM, Arroyo-Izaga M. Nutritional Adequacy and Diet Quality in Colorectal Cancer Patients Postsurgery: A Pilot Study. Nutr Cancer 2016; 68:577-88. [PMID: 27144653 DOI: 10.1080/01635581.2016.1158299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent evidence has shown that an unhealthy diet is associated with a higher risk of tumor recurrence, metastasis, and death among patients with colorectal cancer (CRC). The aims of this study were to assess nutritional adequacy and diet quality in a group of CRC patients postsurgery and to identify possible associations between dietary and nutritional aspects and environmental factors and weight status. This was an observational study conducted on a random sample of 74 patients, aged 50-69 years. Dietary intake was evaluated utilizing a validated frequency questionnaire, and diet quality was evaluated utilizing the Healthy Eating Index for Spanish Diet and the MedDietScore. Data regarding socioeconomic, demographic, lifestyles, dietary supplements use, and body mass index were collected. Subjects followed a diet characterized by a low carbohydrate intake (94% of the cases), excessive protein (48%), high fat intake (67%), and some micronutrient deficiencies. The inadequacy of some nutrients was associated with male gender, overweight/obesity, smoking, and low educational level; and low adherence to the MedDiet was identified in those with a low educational level (adjusted odds ratio = 4.16, P < 0.05). Therefore, such patients should be an important target group when applying educational programs and giving individualized nutritional advice to improve their quality of life.
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Affiliation(s)
- Iker Alegria-Lertxundi
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Maider Alvarez
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Ana M Rocandio
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain.,b BIOMICs Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Marian M de Pancorbo
- b BIOMICs Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain.,c Department of Zoology and Cellular Biology Animal , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
| | - Marta Arroyo-Izaga
- a Department of Pharmacy and Food Sciences , University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain.,b BIOMICs Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU , Vitoria-Gasteiz , Spain
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21
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Sechi G, Sechi E, Fois C, Kumar N. Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutr Rev 2016; 74:281-300. [PMID: 27034475 DOI: 10.1093/nutrit/nuv107] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
B vitamin deficiency is a leading cause of neurological impairment and disability throughout the world. Multiple B vitamin deficiencies often coexist, and thus an understanding of the complex relationships between the different biochemical pathways regulated in the brain by these vitamins may facilitate prompter diagnosis and improved treatment. Particular populations at risk for multiple B vitamin deficiencies include the elderly, people with alcoholism, patients with heart failure, patients with recent obesity surgery, and vegetarians/vegans. Recently, new clinical settings that predispose individuals to B vitamin deficiency have been highlighted. Moreover, other data indicate a possible pathogenetic role of subclinical chronic B vitamin deficiency in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. In light of these findings, this review examines the clinical manifestations of B vitamin deficiency and the effect of B vitamin deficiency on the adult nervous system. The interrelationships of multiple B vitamin deficiencies are emphasized, along with the clinical phenotypes related to B vitamin deficiencies. Recent advances in the clinical determinants and diagnostic clues of B vitamin deficiency, as well as the suggested therapies for B vitamin disorders, are described.
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Affiliation(s)
- GianPietro Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
| | - Elia Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Chiara Fois
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Neeraj Kumar
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
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22
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Abstract
Inborn errors of metabolism are single gene disorders resulting from the defects in the biochemical pathways of the body. Although these disorders are individually rare, collectively they account for a significant portion of childhood disability and deaths. Most of the disorders are inherited as autosomal recessive whereas autosomal dominant and X-linked disorders are also present. The clinical signs and symptoms arise from the accumulation of the toxic substrate, deficiency of the product, or both. Depending on the residual activity of the deficient enzyme, the initiation of the clinical picture may vary starting from the newborn period up until adulthood. Hundreds of disorders have been described until now and there has been a considerable clinical overlap between certain inborn errors. Resulting from this fact, the definite diagnosis of inborn errors depends on enzyme assays or genetic tests. Especially during the recent years, significant achievements have been gained for the biochemical and genetic diagnosis of inborn errors. Techniques such as tandem mass spectrometry and gas chromatography for biochemical diagnosis and microarrays and next-generation sequencing for the genetic diagnosis have enabled rapid and accurate diagnosis. The achievements for the diagnosis also enabled newborn screening and prenatal diagnosis. Parallel to the development the diagnostic methods; significant progress has also been obtained for the treatment. Treatment approaches such as special diets, enzyme replacement therapy, substrate inhibition, and organ transplantation have been widely used. It is obvious that by the help of the preclinical and clinical research carried out for inborn errors, better diagnostic methods and better treatment approaches will high likely be available.
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23
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Hope S, Johannessen CH, Aanonsen NO, Strømme P. The investigation of inborn errors of metabolism as an underlying cause of idiopathic intellectual disability in adults in Norway. Eur J Neurol 2015; 23 Suppl 1:36-44. [DOI: 10.1111/ene.12884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 12/17/2022]
Affiliation(s)
- S. Hope
- Department of Neuro Habilitation; Oslo University Hospital, Ullevål; Oslo Norway
- NORMENT; KG Jebsen Centre for Psychosis Research; Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - C. H. Johannessen
- Department of Neuro Habilitation; Oslo University Hospital, Ullevål; Oslo Norway
| | - N. O. Aanonsen
- Department of Neuro Habilitation; Oslo University Hospital, Ullevål; Oslo Norway
| | - P. Strømme
- Department of Clinical Neurosciences for Children; Women and Children′s Division; Oslo University Hospital, Ullevål; Oslo Norway
- University of Oslo; Oslo Norway
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24
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Froese DS, Kopec J, Fitzpatrick F, Schuller M, McCorvie TJ, Chalk R, Plessl T, Fettelschoss V, Fowler B, Baumgartner MR, Yue WW. Structural Insights into the MMACHC-MMADHC Protein Complex Involved in Vitamin B12 Trafficking. J Biol Chem 2015; 290:29167-77. [PMID: 26483544 PMCID: PMC4705923 DOI: 10.1074/jbc.m115.683268] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Indexed: 11/06/2022] Open
Abstract
Conversion of vitamin B12 (cobalamin, Cbl) into the cofactor forms methyl-Cbl (MeCbl) and adenosyl-Cbl (AdoCbl) is required for the function of two crucial enzymes, mitochondrial methylmalonyl-CoA mutase and cytosolic methionine synthase, respectively. The intracellular proteins MMACHC and MMADHC play important roles in processing and targeting the Cbl cofactor to its destination enzymes, and recent evidence suggests that they may interact while performing these essential trafficking functions. To better understand the molecular basis of this interaction, we have mapped the crucial protein regions required, indicate that Cbl is likely processed by MMACHC prior to interaction with MMADHC, and identify patient mutations on both proteins that interfere with complex formation, via different mechanisms. We further report the crystal structure of the MMADHC C-terminal region at 2.2 Å resolution, revealing a modified nitroreductase fold with surprising homology to MMACHC despite their poor sequence conservation. Because MMADHC demonstrates no known enzymatic activity, we propose it as the first protein known to repurpose the nitroreductase fold solely for protein-protein interaction. Using small angle x-ray scattering, we reveal the MMACHC-MMADHC complex as a 1:1 heterodimer and provide a structural model of this interaction, where the interaction region overlaps with the MMACHC-Cbl binding site. Together, our findings provide novel structural evidence and mechanistic insight into an essential biological process, whereby an intracellular "trafficking chaperone" highly specific for a trace element cofactor functions via protein-protein interaction, which is disrupted by inherited disease mutations.
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Affiliation(s)
- D Sean Froese
- From the Division of Metabolism and Children's Research Center, University Children's, Hospital, CH-8032 Zurich, Switzerland, radiz - Rare Disease Initiative Zurich, Clinical Research Priority Program for Rare Diseases, University of Zurich, CH-8032 Zurich, Switzerland
| | - Jolanta Kopec
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, and
| | - Fiona Fitzpatrick
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, and
| | - Marion Schuller
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, and
| | - Thomas J McCorvie
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, and
| | - Rod Chalk
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, and
| | - Tanja Plessl
- From the Division of Metabolism and Children's Research Center, University Children's, Hospital, CH-8032 Zurich, Switzerland
| | - Victoria Fettelschoss
- From the Division of Metabolism and Children's Research Center, University Children's, Hospital, CH-8032 Zurich, Switzerland
| | - Brian Fowler
- From the Division of Metabolism and Children's Research Center, University Children's, Hospital, CH-8032 Zurich, Switzerland
| | - Matthias R Baumgartner
- From the Division of Metabolism and Children's Research Center, University Children's, Hospital, CH-8032 Zurich, Switzerland, radiz - Rare Disease Initiative Zurich, Clinical Research Priority Program for Rare Diseases, University of Zurich, CH-8032 Zurich, Switzerland, the Zurich Center for Integrative Human Physiology, University of Zurich, 8057 Zurich, Switzerland
| | - Wyatt W Yue
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, and
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25
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Jusufi J, Suormala T, Burda P, Fowler B, Froese DS, Baumgartner MR. Characterization of functional domains of the cblD (MMADHC) gene product. J Inherit Metab Dis 2014; 37:841-9. [PMID: 24722857 DOI: 10.1007/s10545-014-9709-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/14/2014] [Accepted: 03/17/2014] [Indexed: 12/01/2022]
Abstract
In humans vitamin B12 (cobalamin, Cbl) must be converted into two coenzyme forms, methylcobalamin (MeCbl) and adenosylcobalamin (AdoCbl), in order to maintain intracellular homeostasis of homocysteine and methylmalonic acid, respectively. Previously we have shown that in cblD patients three types of MMADHC mutations exist: 1) null mutations N-terminal to Met116 cause isolated methylmalonic aciduria (cblD-MMA) due to AdoCbl deficiency; 2) null mutations across the C-terminus (p.Y140-R250) cause combined methylmalonic aciduria and homocystinuria (cblD-MMA/HC) due to AdoCbl and MeCbl deficiency; 3) missense mutations in a conserved C-terminal region (p.D246-L259) cause isolated homocystinuria (cblD-HC) due to MeCbl deficiency. To better understand the domain boundaries related to MeCbl formation, we made selected point mutations and C-terminal truncations in MMADHC and tested rescue of MeCbl and AdoCbl synthesis in immortalized cblD-MMA/HC patient fibroblasts. Testing 20 mutations (15 missense and five C-terminal truncations) across p.P154-S287 revealed the presence of a region (p.R197-D226) responsible for MeCbl synthesis, which gave a similar cellular phenotype as cblD-HC. Further, mutation of the polypeptide stretch between the new and patient defined regions (p.D226-D246) and directly C-terminal to the patient region (p.L259-R266), gave cellular phenotypes intermediate to those of cblD-HC and cblD-MMA/HC. Finally, C-terminal truncation of more than 20 amino acids resulted in a cblD-MMA/HC like cellular phenotype, while truncation of between ten and 20 amino acids resulted in a cblD-HC like cellular phenotype. These data suggest that specific regions of MMADHC are involved in differential regulation of AdoCbl and MeCbl synthesis and help better define the boundaries of these regions.
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Affiliation(s)
- Jehona Jusufi
- Division for Metabolic Disorders and Children's Research Center, University Children's Hospital, Steinweisstrasse 75, 8032, Zurich, Switzerland
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Patterson MC. Editorial comment: Ataxia, ophthalmoplegia, and impairment of consciousness in a 19 month-old American boy. Semin Pediatr Neurol 2014; 21:144. [PMID: 25149950 DOI: 10.1016/j.spen.2014.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Marc C Patterson
- Division of Child and Adolescent Neurology, Mayo Clinic, Rochester, MN.
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Yan J, Liu L, Roebothan B, Ryan A, Chen Z, Yi Y, Wang P. A preliminary investigation into diet adequacy in senior residents of Newfoundland and Labrador, Canada: a cross-sectional study. BMC Public Health 2014; 14:302. [PMID: 24690512 PMCID: PMC4229985 DOI: 10.1186/1471-2458-14-302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 03/26/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adequate dietary intake is essential to maintain good health. This is particularly true for the elderly. This study investigated the dietary intakes of seniors residing in Newfoundland and Labrador (NL) and assessed the adequacy of nutrients which they consumed as food. METHODS Between November 2012 and January 2013, we recruited senior residents in NL, aged 65 years or older Participants were required to complete two questionnaires, one food-frequency questionnaire (FFQ) and one general health questionnaire (GHQ). Macro- and micro- nutrients in foods consumed were estimated using the Elizabeth Stewart Hands and Associations (ESHA) nutrient analysis software. The nutrient intakes were compared with appropriate components of the dietary reference intakes (DRIs) adopted by Health Canada to determine adequacy. Various descriptive statistical analyses were performed using SPSS. RESULTS One hundred-and-eleven participants (69 females and 42 males) completed the surveys and were included in the analysis. A considerable portion of subjects were overweight (41.7%) or obese (25%), and had at least one chronic illness (86.5%). Many seniors studied did not meet the daily recommendations for dietary intakes of nutrients supported by Health Canada, notably vitamin E (84.7%) and vitamin D (68.5%). Our study also suggests that about 40% of participants consumed more dietary energy as fat than is recommended. CONCLUSION The present study revealed an inadequate consumption of essential nutrients from foods in a noninstitutionalized senior population of NL.
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Affiliation(s)
| | | | | | | | | | | | - Peizhong Wang
- School of Public Health, Tianjin Medical University, Tianjin, China.
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