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Alyazidi AS, Muthaffar OY, Shawli MK, Ahmed RA, Aljefri YF, Baaishrah LS, Jambi AT, Alotibi FA. Phenotypic and Molecular Spectrum of Guanidinoacetate N-Methyltransferase Deficiency: An Analytical Study of a Case Series and a Scoping Review of 53 Cases of Guanidinoacetate N-Methyltransferase. J Microsc Ultrastruct 2024; 12:81-90. [PMID: 39006040 PMCID: PMC11245129 DOI: 10.4103/jmau.jmau_16_22] [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: 02/24/2022] [Revised: 05/24/2022] [Accepted: 06/02/2022] [Indexed: 12/02/2022] Open
Abstract
Background Guanidinoacetate methyltransferase deficiency (GAMT) is an autosomal recessive inborn error of metabolism. A condition that results from a pathogenic variant in the GAMT gene that maps to 19p13.3. The prevalence can be estimated to be up to 1:2,640,000 cases; countries such as Saudi Arabia could have a higher prevalence due to high consanguinity rates. The clinical manifestations that a patient could obtain are broad and start to manifest in the patients' early childhood years. Materials and Methods A thorough review of case reports in January 2022 was conducted. The retrieved literature was screened for demographic data. Patients of all ages were included. Qualitative variables were described as number and percentage (%), and quantitative data were described by the mean and standard deviation. In bivariate data, Chi-square test (χ2) was used and t-test for nonparametric variables. Results Gender distribution was 53% of males and 47% females. Reported age ranged from 8 to 31 months. At the age of onset, 50% of the cases were infants, 28% were toddlers, and 15% were children, concluding that 79% of the reported cases developed symptoms before 5 years old. 68% of the cases developed generalized seizures throughout their life. 84% of the cases expressed a form of developmental delay. 43% of the cases had intellectual disabilities and mental retardation that affected their learning process; most cases required special care. 23% of the affected cases were of consanguineous marriages, and 7% had affected relatives. Conclusion We described four novel case reports, the first to be reported in Saudi Arabia. Seizure was a leading finding in the majority of the cases. Developmental delay was broadly observed. Intellectual delay and language impairments are primary hallmarks. Further understanding and early diagnosis are recommended. Premarital testing of neurogenetic diseases using whole-exome sequencing is probably a future direction, especially in populations with high consanguinity rates.
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Affiliation(s)
- Anas S. Alyazidi
- Undergraduate Student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Y. Muthaffar
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed K. Shawli
- Undergraduate Student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Renad A. Ahmed
- Undergraduate Student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Yara Fahad Aljefri
- Undergraduate Student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Layan Saleh Baaishrah
- Undergraduate Student, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulaziz T. Jambi
- Undergraduate Student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad A. Alotibi
- Undergraduate Student, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Balestrino M, Adriano E, Alì PA, Pardini M. Selective Alteration of the Left Arcuate Fasciculus in Two Patients Affected by Creatine Transporter Deficiency. Brain Sci 2024; 14:337. [PMID: 38671990 PMCID: PMC11048612 DOI: 10.3390/brainsci14040337] [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: 02/08/2024] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: In hereditary creatine transporter deficiency (CTD), there is an absence of creatine in the brain and neurological symptoms are present, including severe language impairment. However, the pathological changes caused by creatine deficiency that generate neuropsychological symptoms have been poorly studied. (2) Aims: To investigate if the language impairment in CTD is underpinned by possible pathological changes. (3) Methods: We used MRI tractography to investigate the trophism of the left arcuate fasciculus, a white matter bundle connecting Wernicke's and Broca's language areas that is specifically relevant for language establishment and maintenance, in two patients (28 and 18 y.o.). (4) Results: The T1 and T2 MRI imaging results were unremarkable, but the left arcuate fasciculus showed a marked decrease in mean fractional anisotropy (FA) compared to healthy controls. In contrast, the FA values in the corticospinal tract were similar to those of healthy controls. Although white matter atrophy has been reported in CTD, this is the first report to show a selective abnormality of the language-relevant arcuate fasciculus, suggesting a possible region-specific impact of creatine deficiency.
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Affiliation(s)
- Maurizio Balestrino
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy; (E.A.); (P.A.A.); (M.P.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Enrico Adriano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy; (E.A.); (P.A.A.); (M.P.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Paolo Alessandro Alì
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy; (E.A.); (P.A.A.); (M.P.)
| | - Matteo Pardini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy; (E.A.); (P.A.A.); (M.P.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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3
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Ren J, Rodriguez L, Johnson T, Henning A, Dhaher YY. 17β-Estradiol Effects in Skeletal Muscle: A 31P MR Spectroscopic Imaging (MRSI) Study of Young Females during Early Follicular (EF) and Peri-Ovulation (PO) Phases. Diagnostics (Basel) 2024; 14:235. [PMID: 38337751 PMCID: PMC10854839 DOI: 10.3390/diagnostics14030235] [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: 12/17/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
The natural variation in estrogen secretion throughout the female menstrual cycle impacts various organs, including estrogen receptor (ER)-expressed skeletal muscle. Many women commonly experience increased fatigue or reduced energy levels in the days leading up to and during menstruation, when blood estrogen levels decline. Yet, it remains unclear whether endogenous 17β-estradiol, a major estrogen component, directly affects the energy metabolism in skeletal muscle due to the intricate and fluctuating nature of female hormones. In this study, we employed 2D 31P FID-MRSI at 7T to investigate phosphoryl metabolites in the soleus muscle of a cohort of young females (average age: 28 ± 6 years, n = 7) during the early follicular (EF) and peri-ovulation (PO) phases, when their blood 17β-estradiol levels differ significantly (EF: 28 ± 18 pg/mL vs. PO: 71 ± 30 pg/mL, p < 0.05), while the levels of other potentially interfering hormones remain relatively invariant. Our findings reveal a reduction in ATP-referenced phosphocreatine (PCr) levels in the EF phase compared to the PO phase for all participants (5.4 ± 4.3%). Furthermore, we observe a linear correlation between muscle PCr levels and blood 17β-estradiol concentrations (r = 0.64, p = 0.014). Conversely, inorganic phosphate Pi and phospholipid metabolite GPC levels remain independent of 17β-estradiol but display a high correlation between the EF and PO phases (p = 0.015 for Pi and p = 0.0008 for GPC). The robust association we have identified between ATP-referenced PCr and 17β-estradiol suggests that 17β-estradiol plays a modulatory role in the energy metabolism of skeletal muscle.
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Affiliation(s)
- Jimin Ren
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Luis Rodriguez
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA;
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Talon Johnson
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Anke Henning
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Yasin Y. Dhaher
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA;
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Post A, Garcia E, Shalaurova I, Matyus SP, González-Delgado JM, Doorenbos CSE, van der Veen Y, Shah SH, Kraus WE, Kremer D, Knobbe TJ, Bakker SJL, Dullaart RPF, Connelly MA. Creatine and creatinine quantified using nuclear magnetic resonance: A method validation study and clinical associations between circulating creatine and fatigue in kidney transplant recipients. Clin Chim Acta 2023; 548:117517. [PMID: 37591418 DOI: 10.1016/j.cca.2023.117517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND A potential contributor to fatigue in kidney transplant recipients (KTR) may be impaired creatine homeostasis. We developed and validated a high-throughput NMR assay allowing for simultaneous measurement of circulating creatine and creatinine, and determined plasma creatine and estimated intramuscular creatine concentrations in KTRs, delineated their determinants and explored their associations with self-reported fatigue. METHODS An NMR assay was developed and validated for measurement of circulating creatinine and creatine concentrations. Plasma creatine and creatinine concentrations were measured in 618 KTR. Fatigue was assessed using the checklist individual strength. Associations of creatine parameters with fatigue was assessed using linear mixed effect models. RESULTS The NMR-based assay had good sensitivity, precision and demonstrated linearity across a large range of values. Among KTR, the mean age was 56 ± 13 years, 62% were men and eGFR was 54 ± 18 ml/min/1.73 m2. Plasma creatine concentration was 27 [19-39] µmol/L. Estimated intramuscular creatine concentration was 27 ± 7 mmol/kg. Higher plasma creatine concentration and higher estimated intramuscular creatine concentration were independently associated with a lower total fatigue score and less motivation problems. CONCLUSION An NMR method for measurement of circulating creatine and creatinine which offers the potential for accurate and efficient quantification was developed. The found associations suggest that improving creatine status may play a beneficial role in mitigating fatigue.
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Affiliation(s)
- Adrian Post
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
| | | | | | | | | | - Caecilia S E Doorenbos
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
| | - Yvonne van der Veen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
| | - Svati H Shah
- Division of Cardiology, Department of Medicine and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27710, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27710, USA.
| | - William E Kraus
- Division of Cardiology, Department of Medicine and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27710, USA.
| | - Daan Kremer
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
| | - Tim J Knobbe
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
| | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
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Metzger GA, Minneci PM, Gehred A, Day A, Klingele KE. Creatine supplementation in the pediatric and adolescent athlete-- A literature review. J Orthop 2023; 38:73-78. [PMID: 37008451 PMCID: PMC10063391 DOI: 10.1016/j.jor.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Background An increase in intra-muscular creatine through supplementation has been proposed as a strategy for improving muscle performance and recovery, with studies showing some benefit for adult athletes who rely on short, explosive movements. We reviewed and summarized the current literature on creatine supplementation in a pediatric and adolescent population. Methods The databases PubMed and EMBASE were queried to identity articles related to the use of creatine supplementation in a healthy pediatric and adolescent population according to the guidelines established by PRISMA. The abstracts of all articles were reviewed to determine relevancy, with those meeting the pre-defined criteria included in the final review. Results A combined total of 9393 articles were identified. Following application of filters and review of abstracts, 13 articles were found to meet criteria and were included in the final review. There was a total of 268 subjects across all studies, with mean age ranging from 11.5 to 18.2 years. More than 75% of the studies were randomized-controlled trials, and 85% involved either soccer players or swimmers. The overall quality of the studies was poor, and there were no consistent findings regarding creatine supplementation and improvements in athletic performance. No studies were designed to address the topic of safety. Conclusions There is a gap in the study of the safety and efficacy of creatine supplementation in adolescents. Additional studies are needed to evaluate the effects of alterations in muscle composition on the growth, development, and performance of the developing athlete. Orthopedic providers should counsel their pediatric and adolescent patients on the current limitations in trying to assess the true risk and benefit of creatine supplementation for the aspiring athlete. Level of evidence Review, III.
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Affiliation(s)
- Gregory A. Metzger
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Peter M. Minneci
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Alison Gehred
- Nationwide Children's Hospital Library, Columbus, OH, USA
| | - Alexis Day
- Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kevin E. Klingele
- Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA
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6
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Creatine Supplementation to Improve Sarcopenia in Chronic Liver Disease: Facts and Perspectives. Nutrients 2023; 15:nu15040863. [PMID: 36839220 PMCID: PMC9958770 DOI: 10.3390/nu15040863] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Creatine supplementation has been one of the most studied and useful ergogenic nutritional support for athletes to improve performance, strength, and muscular mass. Over time creatine has shown beneficial effects in several human disease conditions. This review aims to summarise the current evidence for creatine supplementation in advanced chronic liver disease and its complications, primarily in sarcopenic cirrhotic patients, because this condition is known to be associated with poor prognosis and outcomes. Although creatine supplementation in chronic liver disease seems to be barely investigated and not studied in human patients, its potential efficacy on chronic liver disease is indirectly highlighted in animal models of non-alcoholic fatty liver disease, bringing beneficial effects in the fatty liver. Similarly, encephalopathy and fatigue seem to have beneficial effects. Creatine supplementation has demonstrated effects in sarcopenia in the elderly with and without resistance training suggesting a potential role in improving this condition in patients with advanced chronic liver disease. Creatine supplementation could address several critical points of chronic liver disease and its complications. Further studies are needed to support the clinical burden of this hypothesis.
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Expanding the neuroimaging findings of guanidinoacetate methyltransferase deficiency in an Iranian girl with a homozygous frameshift variant in the GAMT. Neurogenetics 2023; 24:67-78. [PMID: 36633690 DOI: 10.1007/s10048-022-00708-2] [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: 09/09/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Abstract
Guanidinoacetate methyltransferase deficiency (GAMTD) is a treatable neurodevelopmental disorder with normal or nonspecific imaging findings. Here, we reported a 14-month-old girl with GAMTD and novel findings on brain magnetic resonance imaging (MRI).A 14-month-old female patient was referred to Myelin Disorders Clinic due to onset of seizures and developmental regression following routine vaccination at 4 months of age. Brain MRI, prior to initiation of treatment, showed high signal intensity in T2-weighted imaging in bilateral thalami, globus pallidus, subthalamic nuclei, substantia nigra, dentate nuclei, central tegmental tracts in the brainstem, and posterior periventricular white matter which was masquerading for mitochondrial leukodystrophy. Basic metabolic tests were normal except for low urine creatinine; however, exome sequencing identified a homozygous frameshift deletion variant [NM_000156: c.491del; (p.Gly164AlafsTer14)] in the GAMT. Biallelic pathogenic or likely pathogenic variants cause GAMTD. We confirmed the homozygous state for this variant in the proband, as well as the heterozygote state in the parents by Sanger sequencing.MRI features in GAMTD can mimic mitochondrial leukodystrophy. Pediatric neurologists should be aware of variable MRI findings in GAMTD since they would be misleading to other diagnoses.
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Almaghrabi MA, Muthaffar OY, Alahmadi SA, Abdulsbhan MA, Bamusa M, Aljezani MA, Bahowarth SY, Alyazidi AS, Aggad WS. GAMT Deficiency Among Pediatric Population: Clinical and Molecular Characteristics and Management. Child Neurol Open 2023; 10:2329048X231215630. [PMID: 38020815 PMCID: PMC10655665 DOI: 10.1177/2329048x231215630] [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: 08/29/2023] [Revised: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Objective: Analyze the treatment modalities used in real practice by synthesizing available literature. Methods: We reviewed and evaluated 52 cases of GAMT deficiency including 4 novel cases from Saudi Arabia diagnosed using whole-exome sequencing. All data utilized graphical presentation in the form of line charts and illustrated graphs. Results: The mean current age of was 117 months (±29.03) (range 12-372 months). The mean age of disease onset was 28.32 months (±13.68) (range 8 days - 252 months). The most prevalent symptom was developmental delays, mainly speech and motor, seizures, and intellectual disability. The male-to-female ratio was 3:1. Multiple treatments were used, with 54 pharmacological interventions, valproic acid being the most common. Creatinine monohydrate was the prevalent dietary intervention, with 25 patients reporting an improvement. Conclusion: The study suggests that efficient treatment with appropriate dietary intervention can improve patients' health, stressing that personalized treatment programs are essential in managing this disorder.
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Affiliation(s)
- Majdah A. Almaghrabi
- Division of Pediatrics Neurology, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Y. Muthaffar
- Division of Pediatrics Neurology, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sereen A. Alahmadi
- Division of Pediatrics Neurology, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mashael A. Abdulsbhan
- Division of Pediatrics Neurology, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mashael Bamusa
- Division of Pediatrics Neurology, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maram Ahmed Aljezani
- Division of Pediatrics Neurology, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Anas S. Alyazidi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Waheeb S. Aggad
- Department of Anatomy, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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NMR-Based Metabolomics of Rat Hippocampus, Serum, and Urine in Two Models of Autism. Mol Neurobiol 2022; 59:5452-5475. [PMID: 35715683 DOI: 10.1007/s12035-022-02912-5] [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: 11/23/2021] [Accepted: 06/03/2022] [Indexed: 10/18/2022]
Abstract
Autism spectrum disorders (ASDs) are increasingly diagnosed as developmental disabilities of unclear etiology related to genetic, epigenetic, or environmental factors. The diagnosis of ASD in children is based on the recognition of typical behavioral symptoms, while no reliable biomarkers are available. Rats in whom ASD-like symptoms are due to maternal administration of the teratogenic drugs valproate or thalidomide on critical day 11 of pregnancy are widely used models in autism research. The present studies, aimed at detecting changes in the levels of hydrophilic and hydrophobic metabolites, were carried out on 1-month-old rats belonging to the abovementioned two ASD models and on a control group. Analysis of both hydrophilic and hydrophobic metabolite levels gives a broader view of possible mechanisms involved in the pathogenesis of autism. Hippocampal proton magnetic resonance (MRS) spectroscopy and ex vivo nuclear magnetic resonance (NMR) analysis of serum and urine samples were used. The results were analyzed using advanced statistical tests. Both the results of our present MRS studies of the hippocampus and of the NMR studies of body fluids in both ASD models, particularly from the THAL model, appeared to be consistent with previously published NMR results of hippocampal homogenates and data from the literature on autistic children. We detected symptoms of disturbances in neurotransmitter metabolism, energy deficit, and oxidative stress, as well as intestinal malfunction, which shed light on the pathogenesis of ASD and could be used for diagnostic purposes. These results confirm the usefulness of the noninvasive techniques used in ASD studies.
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Low Tissue Creatine: A Therapeutic Target in Clinical Nutrition. Nutrients 2022; 14:nu14061230. [PMID: 35334887 PMCID: PMC8955088 DOI: 10.3390/nu14061230] [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: 02/14/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/25/2022] Open
Abstract
Low tissue creatine characterizes many conditions, including neurodegenerative, cardiopulmonary, and metabolic diseases, with a magnitude of creatine shortfall often corresponds well to a disorder’s severity. A non-invasive monitoring of tissue metabolism with magnetic resonance spectroscopy (MRS) might be a feasible tool to evaluate suboptimal levels of creatine for both predictive, diagnostic, and therapeutic purposes. This mini review paper summarizes disorders with deficient creatine levels and provides arguments for assessing and employing tissue creatine as a relevant target in clinical nutrition.
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Wallery JJ, Kale VP, Novak J, Gibbs S, Do MHT, McKew JC, Terse PS. Evaluation of chronic toxicity of cyclocreatine in beagle dogs after oral gavage administration for up to 23 weeks. Toxicol Appl Pharmacol 2021; 430:115680. [PMID: 34411581 PMCID: PMC8549071 DOI: 10.1016/j.taap.2021.115680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
Cyclocreatine (LUM-001) was evaluated for chronic toxicity (23 weeks) in beagle dogs to support clinical development in patients with creatine transporter deficiency (CTD) disorder. Deionized water (vehicle control) or cyclocreatine was administered by oral gavage twice daily (12 ± 1 h apart) at 20, 40 and 75 mg/kg/dose followed by a recovery period. Due to severe toxicity, the study was terminated earlier than the planned 39 weeks of dosing. Animals in the 20, 40 and 75 mg/kg/dose groups completed 160, 106, and 55 days of dosing, respectively, followed by 30, 55 and 106 days of a recovery period, respectively. Three (25%), 7 (58%), and 7 (58%) animals were euthanized and/or found dead in the 40, 80, and 150 mg/kg/day dose groups, respectively. Clinical signs observed were inappetence, frequent emesis, stool abnormalities, weight loss, lethargy and respiratory distress. Histopathological evaluation revealed congestion, edema, cellular infiltration, fibrin, and/or hemorrhage in the lungs of all dose groups. Additionally, animals in all cyclocreatine treatment groups had perinuclear cytoplasmic vacuoles in the heart, kidneys, skeletal and smooth muscles. After the recovery period, the vacuoles were still observed in the cardiac and renal tissues. Cyclocreatine was absorbed rapidly with mean Tmax within 1 to 2 h and half-life ranged between 2.17 and 2.79 h on Day 1, however, on the final day of dosing, it ranged between 5.80 and 8.77 h (males) and 10.3 to 13.1 h (females). To conclude, in this study the lungs, kidneys, heart, skeletal and smooth muscles were identified as the target organs of cyclocreatine toxicity in beagle dogs.
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Affiliation(s)
| | | | | | | | | | | | - Pramod S Terse
- National Center for Advancing Translational Sciences, National Institute of Health, Bethesda, MD, USA.
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Ostojic SM, Korovljev D, Stajer V. Dietary intake of creatine and risk of medical conditions in U.S. older men and women: Data from the 2017-2018 National Health and Nutrition Examination Survey. Food Sci Nutr 2021; 9:5746-5754. [PMID: 34646542 PMCID: PMC8498075 DOI: 10.1002/fsn3.2543] [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: 05/07/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/24/2022] Open
Abstract
We examined dietary intake of creatine in U.S. men and women aged 65 years and over, and evaluated the association between creatine intake and risk of self-reported medical conditions, and physical functioning/disability variables using data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). The NHANES 2017-2018 target population included the noninstitutionalized civilian resident population of the United States aged 65 years and over. Detailed dietary intake data from NHANES elderly were obtained by dietary interview component through a 24-h dietary recall interview, with estimated individual values for total grams of creatine consumed per day for each respondent. A threshold for dietary intake of creatine used to calculate risk between creatine intake and medical conditions was set at 1.00 g/day. The sample population included 1500 participants aged 65 years and older, of which 1221 individuals (627 men and 594 women) provided detailed dietary data via a dietary interview. Creatine intake across all participants was 0.76 ± 0.79 g/day (95% CI from 0.72 to 0.81). As much as 70% of U.S. elderly consume <1.00 g of creatine per day, with about 1 in 5 individuals (19.8%) consume no creatine at all. Elderly with the suboptimal intake of creatine were found to have 2.62 times higher risk of angina pectoris (adjusted OR = 2.62, 95% CI from 1.14 to 6.01, p = .023) and 2.59 times higher risk of liver conditions (adjusted OR = 2.59, 95% CI from 1.23 to 5.48, p = .013), compared with older counterparts who consume ≥1.00 g of creatine per day after controlling for demographic and nutritional variables. The considerable shortage of dietary creatine is associated with an increased risk of heart and liver conditions, which calls for public measures that foster diets rich in creatine-containing foods, and additional research to investigate the role of creatine in age-related diseases.
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Affiliation(s)
| | | | - Valdemar Stajer
- FSPE Applied Bioenergetics LabUniversity of Novi SadNovi SadSerbia
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Minozzo BR, de Andrade EA, Vellosa JCR, Lipinski LC, Fernandes D, Nardi GM, Rodrigues RP, Kitagawa RR, Girard C, Demougeot C, Beltrame FL. Polyphenolic compounds of Euphorbia umbellata (Pax) Bruyns (Euphorbiaceae) improved endothelial dysfunction through arginase inhibition. Phytother Res 2021; 35:2557-2567. [PMID: 33350522 DOI: 10.1002/ptr.6986] [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: 05/27/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2023]
Abstract
Euphorbia umbellata is used for its anti-inflammatory properties; however, there are limited data available regarding its effects on vascular function. Its bark is rich in polyphenolic compounds, which potentially improve endothelial dysfunction (ED). This study proposes to investigate the effects of E. umbellata bark extracts and its polyphenolic compounds on arginase (ARG) activity and nitric oxide (NO)-related targets. Chromatographic procedures were used for the chemical characterisation of the extracts. Furthermore, in silico (molecular docking), in vitro (ARG inhibition), in vivo (streptozotocin-induced hyperglycemia model), and ex vivo (l-arginine metabolism, vascular reactivity, western blot, and biochemical) techniques were carried out. Quercetin, gallic acid, and ellagic acid were identified in the extracts. In silico screening predicted that gallic acid and quercetin would have the most promising interactions with ARG -identified cavities. This was confirmed in vitro as both compounds had a direct inhibitory effect on ARG, as was the case regarding the extracts. Oral treatment preserved endothelium-dependent vasodilation through ARG inhibition together with an increase in l-arginine bioavailability and endothelial NO synthase expression. Biochemical parameters determined the lack of toxicity for sub-chronic treatment. E. umbellata bark extracts and its compounds can contribute to ED treatment, at least partly, through the inhibition of vascular ARG.
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Affiliation(s)
- Bruno Rodrigo Minozzo
- Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Brazil
| | - Evelyn Assis de Andrade
- Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Brazil
| | | | | | - Daniel Fernandes
- Department of Pharmacology, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Geisson Marcos Nardi
- Department of Morphology, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | - Corine Girard
- PEPITE EA 4267, University Bourgogne Franche-Comté, Besançon, France
| | - Céline Demougeot
- PEPITE EA 4267, University Bourgogne Franche-Comté, Besançon, France
| | - Flávio Luís Beltrame
- Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Brazil
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15
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Post A, Schutten JC, Kremer D, van der Veen Y, Groothof D, Sotomayor CG, Koops CA, de Blaauw P, Kema IP, Westerhuis R, Wallimann T, Heiner-Fokkema MR, Bakker SJL, Franssen CFM. Creatine homeostasis and protein energy wasting in hemodialysis patients. J Transl Med 2021; 19:115. [PMID: 33743724 PMCID: PMC7981955 DOI: 10.1186/s12967-021-02780-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/08/2021] [Indexed: 12/19/2022] Open
Abstract
Muscle wasting, low protein intake, hypoalbuminemia, low body mass, and chronic fatigue are prevalent in hemodialysis patients. Impaired creatine status may be an often overlooked, potential contributor to these symptoms. However, little is known about creatine homeostasis in hemodialysis patients. We aimed to elucidate creatine homeostasis in hemodialysis patients by assessing intradialytic plasma changes as well as intra- and interdialytic losses of arginine, guanidinoacetate, creatine and creatinine. Additionally, we investigated associations of plasma creatine concentrations with low muscle mass, low protein intake, hypoalbuminemia, low body mass index, and chronic fatigue. Arginine, guanidinoacetate, creatine and creatinine were measured in plasma, dialysate, and urinary samples of 59 hemodialysis patients. Mean age was 65 ± 15 years and 63% were male. During hemodialysis, plasma concentrations of arginine (77 ± 22 to 60 ± 19 μmol/L), guanidinoacetate (1.8 ± 0.6 to 1.0 ± 0.3 μmol/L), creatine (26 [16–41] to 21 [15–30] μmol/L) and creatinine (689 ± 207 to 257 ± 92 μmol/L) decreased (all P < 0.001). During a hemodialysis session, patients lost 1939 ± 871 μmol arginine, 37 ± 20 μmol guanidinoacetate, 719 [399–1070] μmol creatine and 15.5 ± 8.4 mmol creatinine. In sex-adjusted models, lower plasma creatine was associated with a higher odds of low muscle mass (OR per halving: 2.00 [1.05–4.14]; P = 0.04), low protein intake (OR: 2.13 [1.17–4.27]; P = 0.02), hypoalbuminemia (OR: 3.13 [1.46–8.02]; P = 0.008) and severe fatigue (OR: 3.20 [1.52–8.05]; P = 0.006). After adjustment for potential confounders, these associations remained materially unchanged. Creatine is iatrogenically removed during hemodialysis and lower plasma creatine concentrations were associated with higher odds of low muscle mass, low protein intake, hypoalbuminemia, and severe fatigue, indicating a potential role for creatine supplementation.
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Affiliation(s)
- Adrian Post
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands.
| | - Joëlle C Schutten
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Daan Kremer
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Yvonne van der Veen
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Dion Groothof
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Camilo G Sotomayor
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Christa A Koops
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9713 GZ, the Netherlands
| | - Pim de Blaauw
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9713 GZ, the Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9713 GZ, the Netherlands
| | - Ralf Westerhuis
- Dialysis Center Groningen, 9713 GZ, Groningen, The Netherlands
| | | | - M Rebecca Heiner-Fokkema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9713 GZ, the Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Casper F M Franssen
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
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16
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Ma Y, Zhou H, Li C, Zou X, Luo X, Wu L, Li T, Chen X, Mao M, Huang Y, Li E, An Y, Zhang L, Wang T, Xu X, Yan W, Jiang Y, Wang Y. Differential Metabolites in Chinese Autistic Children: A Multi-Center Study Based on Urinary 1H-NMR Metabolomics Analysis. Front Psychiatry 2021; 12:624767. [PMID: 34045978 PMCID: PMC8144639 DOI: 10.3389/fpsyt.2021.624767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/16/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Autism spectrum disorder (ASD) is a group of early-onset neurodevelopmental disorders. However, there is no valuable biomarker for the early diagnosis of ASD. Our large-scale and multi-center study aims to identify metabolic variations between ASD and healthy children and to investigate differential metabolites and associated pathogenic mechanisms. Methods: One hundred and seventeen autistic children and 119 healthy children were recruited from research centers of 7 cities. Urine samples were assayed by 1H-NMR metabolomics analysis to detect metabolic variations. Multivariate statistical analysis, including principal component analysis (PCA), and orthogonal projection to latent structure discriminant analysis (OPLS-DA), as well as univariate analysis were used to assess differential metabolites between the ASD and control groups. The differential metabolites were further analyzed by receiver operating characteristics (ROC) curve analysis and metabolic pathways analysis. Results: Compared with the control group, the ASD group showed higher levels of glycine, guanidinoacetic acid, creatine, hydroxyphenylacetylglycine, phenylacetylglycine, and formate and lower levels of 3-aminoisobutanoic acid, alanine, taurine, creatinine, hypoxanthine, and N-methylnicotinamide. ROC curve showed relatively significant diagnostic values for hypoxanthine [area under the curve (AUC) = 0.657, 95% CI 0.588 to 0.726], creatinine (AUC = 0.639, 95% CI 0.569 to 0.709), creatine (AUC = 0.623, 95% CI 0.552 to 0.694), N-methylnicotinamide (AUC = 0.595, 95% CI 0.523 to 0.668), and guanidinoacetic acid (AUC = 0.574, 95% CI 0.501 to 0.647) in the ASD group. Combining the metabolites creatine, creatinine and hypoxanthine, the AUC of the ROC curve reached 0.720 (95% CI 0.659 to 0.777). Significantly altered metabolite pathways associated with differential metabolites were glycine, serine and threonine metabolism, arginine and proline metabolism, and taurine and hypotaurine metabolism. Conclusions: Urinary amino acid metabolites were significantly altered in children with ASD. Amino acid metabolic pathways might play important roles in the pathogenic mechanisms of ASD.
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Affiliation(s)
- Yu Ma
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Hao Zhou
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang, China
| | - Chunpei Li
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaobing Zou
- Child Development Behaviour Centre, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lijie Wu
- Department of Children and Adolescent Health, School of Public Health, Harbin Medical University, Harbin, China
| | - Tingyu Li
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiang Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meng Mao
- Department of Child Health Care, Chengdu Women and Children's Hospital, Chengdu, China
| | - Yi Huang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Erzhen Li
- Department of Neurology, Capital Institute of Paediatrics, Beijing, China
| | - Yanpeng An
- State Key Laboratory of Genetic Engineering, Metabonomics and Systems Biology Laboratory, School of Life Sciences, Fudan University, Shanghai, China
| | - Lili Zhang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Tianqi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiu Xu
- Department of Child Health Care, Children's Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Yonghui Jiang
- Department of Genetics and Paediatrics, Yale School of Medicine, New Haven, CT, United States
| | - Yi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, China
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17
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Kale VP, Wallery J, Novak J, Gibbs S, Bourdi M, Do MHT, McKew JC, Terse PS. Evaluation of chronic toxicity of cyclocreatine, a creatine analog, in Sprague Dawley rat after oral gavage administration for up to 26 weeks. Regul Toxicol Pharmacol 2020; 117:104750. [PMID: 32745584 DOI: 10.1016/j.yrtph.2020.104750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022]
Abstract
Cyclocreatine (LUM-001), a creatine analog, was evaluated for its nonclinical toxicity in Sprague Dawley (SD) rats. Deionized water as a vehicle control article or cyclocreatine was administered by oral gavage twice daily (approximately 12 ± 1 h apart) at 30, 100 and 300 mg/kg/dose levels in rats up to 26 weeks followed by a 28-day recovery period. Due to an increased incidence of seizures, the 600 mg/kg/day dose group males were dosed only for 16-weeks followed by a 14-week recovery period. Thirteen males and four females from 600 mg/kg/day dose group were sacrificed at interim on Day 113 to study plausible brain lesions and not due to moribundity. There was a dose dependent increase in the number of seizure incidences in ≥60 mg/kg/day males and 600 mg/kg/day females. Microscopically, higher incidences of vacuoles in the brain at 600 mg/kg/day in both sexes, thyroid follicular atrophy and follicular cell hypertrophy at ≥200 mg/kg/day in males and 600 mg/kg/day in females, and seminiferous tubular degeneration and/or interstitial edema in testes at ≥200 mg/kg/day were observed. Mean plasma half-life of cyclocreatine was between 3.5 and 6.5 h. In conclusion, chronic administration of cyclocreatine by oral gavage in Sprague Dawley rats induced the seizures and microscopic lesions in the brain, testes and thyroid. Based on the results of this study the highest tested dose of 600 mg/kg/day (mean Cmax of 151.5 μg/mL; AUC0-24 of 1970 h*μg/mL) was considered the maximum tolerated dose (MTD) in SD rats.
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Affiliation(s)
| | | | | | | | - Mohammed Bourdi
- National Center for Advancing Translational Sciences, National Institute of Health, Bethesda, MD, USA
| | | | | | - Pramod S Terse
- National Center for Advancing Translational Sciences, National Institute of Health, Bethesda, MD, USA.
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18
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Sinha A, Ahmed S, George C, Tsagaris M, Naufer A, von Both I, Tkachyova I, van Eede M, Henkelman M, Schulze A. Magnetic resonance imaging reveals specific anatomical changes in the brain of Agat- and Gamt-mice attributed to creatine depletion and guanidinoacetate alteration. J Inherit Metab Dis 2020; 43:827-842. [PMID: 31951021 DOI: 10.1002/jimd.12215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/30/2019] [Accepted: 01/09/2020] [Indexed: 11/07/2022]
Abstract
Arginine:glycine amidinotransferase- and guanidinoacetate methyltransferase deficiency are severe neurodevelopmental disorders. It is not known whether mouse models of disease express a neuroanatomical phenotype. High-resolution magnetic resonance imaging (MRI) with advanced image analysis was performed in perfused, fixed mouse brains encapsulated with the skull from male, 10-12 week old Agat -exc and B6J.Cg-Gamt tm1Isb mice (n = 48; n = 8 per genotype, strain). T2-weighted MRI scans were nonlinearly aligned to a 3D atlas of the mouse brain with 62 structures identified. Local differences in brain shape related to genotype were assessed by analysis of deformation fields. Creatine (Cr) and guanidinoacetate (GAA) were measured with high-performance liquid chromatography (HPLC) in brain homogenates (n = 24; n = 4 per genotype, strain) after whole-body perfusion. Cr was decreased in the brain of Agat- and Gamt mutant mice. GAA was decreased in Agat-/- and increased in Gamt-/- . Body weight and brain volume were lower in Agat-/- than in Gamt-/- . The analysis of entire brain structures revealed corpus callosum, internal capsule, fimbria and hypothalamus being different between the genotypes in both strains. Eighteen and fourteen significant peaks (local areas of difference in relative size) were found in Agat- and Gamt mutants, respectively. Comparing Agat-/- with Gamt-/- , we found changes in three brain regions, lateral septum, amygdala, and medulla. Intra-strain differences in four brain structures can be associated with Cr deficiency, while the inter-strain differences in three brain structures of the mutant mice may relate to GAA. Correlating these neuroanatomical findings with gene expression data implies the role of Cr metabolism in the developing brain and the importance of early intervention in patients with Cr deficiency syndromes.
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Affiliation(s)
- Ankit Sinha
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sohail Ahmed
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Chris George
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melina Tsagaris
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amriya Naufer
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ingo von Both
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ilona Tkachyova
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Matthijs van Eede
- Mouse Imaging Centre, Toronto Center of Phenogenomics, Toronto, Ontario, Canada
| | - Mark Henkelman
- Mouse Imaging Centre, Toronto Center of Phenogenomics, Toronto, Ontario, Canada
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andreas Schulze
- Genetics and Genome Biology Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Biochemistry, University of Toronto, Toronto, Ontario, Canada
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19
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Glinton KE, Elsea SH. Untargeted Metabolomics for Autism Spectrum Disorders: Current Status and Future Directions. Front Psychiatry 2019; 10:647. [PMID: 31551836 PMCID: PMC6746843 DOI: 10.3389/fpsyt.2019.00647] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/12/2019] [Indexed: 12/20/2022] Open
Abstract
Autism spectrum disorders (ASDs) are a group of neurodevelopment disorders characterized by childhood onset deficits in social communication and interaction. Although the exact etiology of most cases of ASDs is unknown, a portion has been proposed to be associated with various metabolic abnormalities including mitochondrial dysfunction, disorders of cholesterol metabolism, and folate abnormalities. Targeted biochemical testing like plasma amino acid and acylcarnitine profiles have demonstrated limited utility in helping to diagnose and manage such patients. Untargeted metabolomics has emerged, however, as a promising tool in screening for underlying biochemical abnormalities and managing treatment and as a means of investigating possible novel biomarkers for the disorder. Here, we review the principles and methodology behind untargeted metabolomics, recent pilot studies utilizing this technology, and areas in which it may be integrated into the care of children with this disorder in the future.
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Affiliation(s)
- Kevin E. Glinton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
| | - Sarah H. Elsea
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States
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20
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Balestrino M, Adriano E. Beyond sports: Efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscle. Med Res Rev 2019; 39:2427-2459. [PMID: 31012130 DOI: 10.1002/med.21590] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/26/2019] [Accepted: 04/02/2019] [Indexed: 01/16/2023]
Abstract
Creatine is pivotal in energy metabolism of muscle and brain cells, both in physiological and in pathological conditions. Additionally, creatine facilitates the differentiation of muscle and neuronal cells. Evidence of effectiveness of creatine supplementation in improving several clinical conditions is now substantial, and we review it in this paper. In hereditary diseases where its synthesis is impaired, creatine has a disease-modifying capacity, especially when started soon after birth. Strong evidence, including a Cochrane meta-analysis, shows that it improves muscular strength and general well-being in muscular dystrophies. Significant evidence exists also of its effectiveness in secondary prevention of statin myopathy and of treatment-resistant depression in women. Vegetarians and vegans do not consume any dietary creatine and must synthesize all they need, spending most of their methylation capacity. Nevertheless, they have a lower muscular concentration of creatine. Creatine supplementation has proved effective in increasing muscular and neuropsychological performance in vegetarians or vegans and should, therefore, be recommended especially in those of them who are athletes, heavy-duty laborers or who undergo intense mental effort. Convincing evidence also exists of creatine effectiveness in muscular atrophy and sarcopenia in the elderly, and in brain energy shortage (mental fatigue, sleep deprivation, environmental hypoxia as in mountain climbing, and advanced age). Furthermore, we review more randomized, placebo-controlled trials showing that creatine supplementation is safe up to 20 g/d, with a possible caveat only in people with kidney disease. We trust that the evidence we review will be translated into clinical practice and will spur more research on these subjects.
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Affiliation(s)
- Maurizio Balestrino
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University of Genova, Genova, Italy.,Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Enrico Adriano
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University of Genova, Genova, Italy
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21
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Dome P, Tombor L, Lazary J, Gonda X, Rihmer Z. Natural health products, dietary minerals and over-the-counter medications as add-on therapies to antidepressants in the treatment of major depressive disorder: a review. Brain Res Bull 2019; 146:51-78. [DOI: 10.1016/j.brainresbull.2018.12.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/04/2018] [Accepted: 12/26/2018] [Indexed: 12/23/2022]
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22
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Chen L, Barker PB, Weiss RG, van Zijl PCM, Xu J. Creatine and phosphocreatine mapping of mouse skeletal muscle by a polynomial and Lorentzian line-shape fitting CEST method. Magn Reson Med 2019; 81:69-78. [PMID: 30246265 PMCID: PMC6258268 DOI: 10.1002/mrm.27514] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/19/2018] [Accepted: 08/10/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To obtain high-resolution Cr and PCr maps of mouse skeletal muscle using a polynomial and Lorentzian line-shape fitting (PLOF) CEST method. METHODS Wild-type mice and guanidinoacetate N-methyltransferase-deficient (GAMT-/-) mice that have low Cr and PCr concentrations in muscle were used to assign the Cr and PCr peaks in the Z-spectrum at 11.7 T. A PLOF method was proposed to simultaneously extract and quantify the Cr and PCr by assuming a polynomial function for the background and 2 Lorentzian functions for the CEST peaks at 1.95 ppm and 2.5 ppm. RESULTS The Z-spectra of phantoms revealed that PCr has 2 CEST peaks (2 ppm and 2.5 ppm), whereas Cr only showed 1 peak at 2 ppm. Comparison of the Z-spectra of wild-type and GAMT-/- mice indicated that, contrary to brain, there was no visible protein guanidinium peak in the skeletal-muscle Z-spectrum, which allowed us to extract clean PCr and Cr CEST signals. High-resolution PCr and Cr concentration maps of mouse skeletal muscle were obtained by the PLOF CEST method after calibration with in vivo MRS. CONCLUSIONS The PLOF method provides an efficient way to map Cr and PCr concentrations simultaneously in the skeletal muscle at high MRI field.
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Affiliation(s)
- Lin Chen
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter B. Barker
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert G. Weiss
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter C. M. van Zijl
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jiadi Xu
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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23
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Lin Lin Lee V, Kar Meng Choo B, Chung YS, P Kundap U, Kumari Y, Shaikh MF. Treatment, Therapy and Management of Metabolic Epilepsy: A Systematic Review. Int J Mol Sci 2018; 19:ijms19030871. [PMID: 29543761 PMCID: PMC5877732 DOI: 10.3390/ijms19030871] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 01/17/2023] Open
Abstract
Metabolic epilepsy is a metabolic abnormality which is associated with an increased risk of epilepsy development in affected individuals. Commonly used antiepileptic drugs are typically ineffective against metabolic epilepsy as they do not address its root cause. Presently, there is no review available which summarizes all the treatment options for metabolic epilepsy. Thus, we systematically reviewed literature which reported on the treatment, therapy and management of metabolic epilepsy from four databases, namely PubMed, Springer, Scopus and ScienceDirect. After applying our inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed a total of 43 articles. Based on the reviewed articles, we summarized the methods used for the treatment, therapy and management of metabolic epilepsy. These methods were tailored to address the root causes of the metabolic disturbances rather than targeting the epilepsy phenotype alone. Diet modification and dietary supplementation, alone or in combination with antiepileptic drugs, are used in tackling the different types of metabolic epilepsy. Identification, treatment, therapy and management of the underlying metabolic derangements can improve behavior, cognitive function and reduce seizure frequency and/or severity in patients.
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Affiliation(s)
- Vanessa Lin Lin Lee
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| | - Brandon Kar Meng Choo
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| | - Yin-Sir Chung
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| | - Uday P Kundap
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| | - Yatinesh Kumari
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| | - Mohd Farooq Shaikh
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
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24
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Affiliation(s)
| | - Roger Harris
- Formerly University of Chichester, Chichester, UK.
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25
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Adriano E, Gulino M, Arkel M, Salis A, Damonte G, Liessi N, Millo E, Garbati P, Balestrino M. Di-acetyl creatine ethyl ester, a new creatine derivative for the possible treatment of creatine transporter deficiency. Neurosci Lett 2018; 665:217-223. [DOI: 10.1016/j.neulet.2017.12.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/30/2017] [Accepted: 12/07/2017] [Indexed: 12/30/2022]
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Chen L, Zeng H, Xu X, Yadav NN, Cai S, Puts NA, Barker PB, Li T, Weiss RG, van Zijl PCM, Xu J. Investigation of the contribution of total creatine to the CEST Z-spectrum of brain using a knockout mouse model. NMR IN BIOMEDICINE 2017; 30:10.1002/nbm.3834. [PMID: 28961344 PMCID: PMC5685917 DOI: 10.1002/nbm.3834] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/25/2017] [Accepted: 08/26/2017] [Indexed: 05/08/2023]
Abstract
The current study aims to assign and estimate the total creatine (tCr) signal contribution to the Z-spectrum in mouse brain at 11.7 T. Creatine (Cr), phosphocreatine (PCr) and protein phantoms were used to confirm the presence of a guanidinium resonance at this field strength. Wild-type (WT) and knockout mice with guanidinoacetate N-methyltransferase deficiency (GAMT-/-), which have low Cr and PCr concentrations in the brain, were used to assign the tCr contribution to the Z-spectrum. To estimate the total guanidinium concentrations, two pools for the Z-spectrum around 2 ppm were assumed: (i) a Lorentzian function representing the guanidinium chemical exchange saturation transfer (CEST) at 1.95 ppm in the 11.7-T Z-spectrum; and (ii) a background signal that can be fitted by a polynomial function. Comparison between the WT and GAMT-/- mice provided strong evidence for three types of contribution to the peak in the Z-spectrum at 1.95 ppm, namely proteins, Cr and PCr, the latter fitted as tCr. A ratio of 20 ± 7% (protein) and 80 ± 7% tCr was found in brain at 2 μT and 2 s saturation. Based on phantom experiments, the tCr peak was estimated to consist of about 83 ± 5% Cr and 17 ± 5% PCr. Maps for tCr of mouse brain were generated based on the peak at 1.95 ppm after concentration calibration with in vivo magnetic resonance spectroscopy.
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Affiliation(s)
- Lin Chen
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen, China
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Haifeng Zeng
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Xiang Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Nirbhay N. Yadav
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Shuhui Cai
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen, China
| | - Nicolaas A. Puts
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Tong Li
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Robert G. Weiss
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter C. M. van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Jiadi Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
- Corresponding Author: Jiadi Xu, Ph.D. Kennedy Krieger Institute, Johns Hopkins University School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, , Tel: 443-923-9572, Fax: 443-923-9505
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Tacke M, Neubauer BA, Gerstl L, Roser T, Rémi J, Borggraefe I. [Epilepsy-new diagnostic tools, old drugs? : Therapeutic consequences of epilepsy genetics]. DER NERVENARZT 2017; 88:1385-1394. [PMID: 28932874 DOI: 10.1007/s00115-017-0427-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent advances in the field of epilepsy genetics have led to an increased fraction of patients with epilepsies where the etiology of the disease could be identified. Nevertheless, there is some criticism regarding the use of epilepsy genetics because in many cases the identification of a pathogenetic mutation does not lead to an adaptation of therapy or to an improved prognosis. In addition, the interpretation of genetic results might be complicated due to the considerable numbers of variants of unclear significance. OBJECTIVE This publication presents the arguments in favour of a broad use of genetic investigations for children with epilepsies. Several diseases where a genetic diagnosis does in fact have direct therapeutic consequences are mentioned. In addition, the indirect impact of an established etiology, encompassing the avoidance of unnecessary diagnostic measures, possibility of genetic counselling, and the easing of the psychologic burden for the caregivers, should not be underestimated. CONCLUSION The arguments in favour of broad genetic diagnostics prevail notwithstanding the lack of relevant new developments regarding the therapy.
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Affiliation(s)
- M Tacke
- Abteilung für Pädiatrische Neurologie und Entwicklungsneurologie, LMU Zentrum - iSPZ Hauner, Sektion für Pädiatrische Epileptologie, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Universität München, Lindwurmstr. 4, 80337, München, Deutschland
| | - B A Neubauer
- Abteilung für Neuropädiatrie, Sozialpädiatrie und Epileptologie, Universitätskinderklinik, Universität Gießen-Marburg, Gießen, Deutschland
| | - L Gerstl
- Abteilung für Pädiatrische Neurologie und Entwicklungsneurologie, LMU Zentrum - iSPZ Hauner, Sektion für Pädiatrische Epileptologie, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Universität München, Lindwurmstr. 4, 80337, München, Deutschland
| | - T Roser
- Abteilung für Pädiatrische Neurologie und Entwicklungsneurologie, LMU Zentrum - iSPZ Hauner, Sektion für Pädiatrische Epileptologie, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Universität München, Lindwurmstr. 4, 80337, München, Deutschland
| | - J Rémi
- Neurologische Klinik und Poliklinik & Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ), Campus Großhadern, Klinikum der Universität München, München, Deutschland.,Interdisziplinäres Epilepsiezentrum am Campus Großhadern und im Dr. von Haunerschen Kinderspital, Klinikum der Universität München, München, Deutschland
| | - I Borggraefe
- Abteilung für Pädiatrische Neurologie und Entwicklungsneurologie, LMU Zentrum - iSPZ Hauner, Sektion für Pädiatrische Epileptologie, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Universität München, Lindwurmstr. 4, 80337, München, Deutschland. .,Interdisziplinäres Epilepsiezentrum am Campus Großhadern und im Dr. von Haunerschen Kinderspital, Klinikum der Universität München, München, Deutschland.
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Cameron JM, Levandovskiy V, Roberts W, Anagnostou E, Scherer S, Loh A, Schulze A. Variability of Creatine Metabolism Genes in Children with Autism Spectrum Disorder. Int J Mol Sci 2017; 18:ijms18081665. [PMID: 28758966 PMCID: PMC5578055 DOI: 10.3390/ijms18081665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/19/2017] [Accepted: 07/25/2017] [Indexed: 12/23/2022] Open
Abstract
Creatine deficiency syndrome (CDS) comprises three separate enzyme deficiencies with overlapping clinical presentations: arginine:glycine amidinotransferase (GATM gene, glycine amidinotransferase), guanidinoacetate methyltransferase (GAMT gene), and creatine transporter deficiency (SLC6A8 gene, solute carrier family 6 member 8). CDS presents with developmental delays/regression, intellectual disability, speech and language impairment, autistic behaviour, epileptic seizures, treatment-refractory epilepsy, and extrapyramidal movement disorders; symptoms that are also evident in children with autism. The objective of the study was to test the hypothesis that genetic variability in creatine metabolism genes is associated with autism. We sequenced GATM, GAMT and SLC6A8 genes in 166 patients with autism (coding sequence, introns and adjacent untranslated regions). A total of 29, 16 and 25 variants were identified in each gene, respectively. Four variants were novel in GATM, and 5 in SLC6A8 (not present in the 1000 Genomes, Exome Sequencing Project (ESP) or Exome Aggregation Consortium (ExAC) databases). A single variant in each gene was identified as non-synonymous, and computationally predicted to be potentially damaging. Nine variants in GATM were shown to have a lower minor allele frequency (MAF) in the autism population than in the 1000 Genomes database, specifically in the East Asian population (Fisher’s exact test). Two variants also had lower MAFs in the European population. In summary, there were no apparent associations of variants in GAMT and SLC6A8 genes with autism. The data implying there could be a lower association of some specific GATM gene variants with autism is an observation that would need to be corroborated in a larger group of autism patients, and with sub-populations of Asian ethnicities. Overall, our findings suggest that the genetic variability of creatine synthesis/transport is unlikely to play a part in the pathogenesis of autism spectrum disorder (ASD) in children.
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Affiliation(s)
- Jessie M Cameron
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, ON M5G 0A4, Canada.
| | - Valeriy Levandovskiy
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, ON M5G 0A4, Canada.
| | - Wendy Roberts
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Holland Bloorview Kids Rehabilitation Hospital, 150 Kigour Rd, Toronto, ON M4G 1R8, Canada.
| | - Evdokia Anagnostou
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Holland Bloorview Kids Rehabilitation Hospital, 150 Kigour Rd, Toronto, ON M4G 1R8, Canada.
| | - Stephen Scherer
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, ON M5G 0A4, Canada.
- The Centre for Applied Genomics and Genetics and Genome Biology, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
- McLaughlin Centre and Department of Molecular Genetics, 686 Bay Street, 13th Floor, Peter Gilgan Center for Research and Learning, Toronto, ON M5G 0A4, Canada.
| | - Alvin Loh
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Surrey Place Center, 2 Surrey Place, Toronto, ON M5S 2C2, Canada.
| | - Andreas Schulze
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, ON M5G 0A4, Canada.
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Department of Biochemistry, University of Toronto, Toronto, ON M5S 1A8, Canada.
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Xu W, Lin D, Huang C. NMR-based metabolomic analysis for the effects of creatine supplementation on mouse myoblast cell line C2C12. Acta Biochim Biophys Sin (Shanghai) 2017; 49:617-627. [PMID: 28475656 DOI: 10.1093/abbs/gmx043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Indexed: 12/25/2022] Open
Abstract
Creatine (Cr) supplementation has drawn much attention from researchers owing to its widespread efficacy in sports, and more recently, in therapeutic fields. However, the underlying molecular mechanisms remain elusive. Here, we performed nuclear magnetic resonance-based metabolomic analysis to address the metabolic profile of aqueous extracts from the mouse myoblast cell line C2C12 exposed to 2 mM Cr for 24 h (the Cr-treated group). Results showed that Cr supplementation facilitated the proliferation of C2C12 myoblasts. Both pattern recognition and hierarchical cluster analyses demonstrated that the metabolic profiles of the Cr-treated and control groups were distinctly different. We identified 13 characteristic metabolites significantly responsible for the discrimination of metabolic profiles between the two groups, through orthogonal projection to latent structures discriminant analysis and independent samples t-test. We further verified the discrimination performances of these metabolites by conducting univariate receiver operating characteristic curve analysis. Compared with the control group, the Cr-treated group exhibited increased levels of Cr, phosphocreatine (PCr), glutathione (GSH), and glucose, but decreased levels of leucine, valine, isoleucine, phenylalanine, methionine, choline, O-phosphocholine, sn-glycero-3-phosphocholine, and glycerol. Our results demonstrated that Cr supplementation upregulated PCr and glucose, promoted trichloroacetic acid cycle anaplerotic flux and GSH-mediated antioxidant capacity, and stabilized lipid membranes through suppressing glycerophospholipid metabolism. Our work provides new clues to the molecular mechanisms underlying the pleiotropic effects of Cr in muscle cells.
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Affiliation(s)
- Wenqi Xu
- The Key Laboratory for Chemical Biology of Fujian Province, MOE Key Laboratory of Spectrochemical Analysis & Instrumentation, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Donghai Lin
- The Key Laboratory for Chemical Biology of Fujian Province, MOE Key Laboratory of Spectrochemical Analysis & Instrumentation, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Caihua Huang
- Exercise and Health Laboratory, Xiamen University of Technology, Xiamen 361024, China
- Exercise and Rehabilitation Laboratory, Fujian Medical University, Fuzhou 350104, China
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30
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Wallimann T, Riek U, Möddel M. Intradialytic creatine supplementation: A scientific rationale for improving the health and quality of life of dialysis patients. Med Hypotheses 2017; 99:1-14. [DOI: 10.1016/j.mehy.2016.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/03/2016] [Indexed: 12/19/2022]
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Stajer V, Trivic T, Drid P, Vranes M, Ostojic SM. A single session of exhaustive exercise markedly decreases circulating levels of guanidinoacetic acid in healthy men and women. Appl Physiol Nutr Metab 2016; 41:1100-1103. [PMID: 27690568 DOI: 10.1139/apnm-2016-0102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We evaluated the effects of exercise on circulating concentrations of guanidinoacetic acid (GAA) and creatine in 23 healthy volunteers subjected to running to exhaustion and free-weight bench-press to volitional failure. Blood was taken before and following each exercise session. Running induced a significant decrease in serum GAA by 20.1% (P < 0.001), while free-weight exercise reduced GAA by 11.7% (P < 0.001), suggesting the possible use of serum GAA as a novel biomarker of exhaustion.
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Affiliation(s)
- Valdemar Stajer
- a Applied Bioenergetics Lab, Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, Novi Sad 21000, Serbia
| | - Tatjana Trivic
- a Applied Bioenergetics Lab, Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, Novi Sad 21000, Serbia
| | - Patrik Drid
- a Applied Bioenergetics Lab, Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, Novi Sad 21000, Serbia
| | - Milan Vranes
- b Faculty of Sciences, University of Novi Sad, Novi Sad 21000, Serbia
| | - Sergej M Ostojic
- a Applied Bioenergetics Lab, Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, Novi Sad 21000, Serbia.,c University of Belgrade School of Medicine, Belgrade, Belgrade 11000, Serbia
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32
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Schulze A, Tran C, Levandovskiy V, Patel V, Cortez MA. Systemic availability of guanidinoacetate affects GABAA receptor function and seizure threshold in GAMT deficient mice. Amino Acids 2016; 48:2041-7. [PMID: 26898547 DOI: 10.1007/s00726-016-2197-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/08/2016] [Indexed: 11/29/2022]
Abstract
Deficiency of guanidinoacetate methyltransferase (GAMT) causes creatine depletion and guanidinoacetate accumulation in brain with the latter deemed to be responsible for the severe seizure disorder seen in affected patients. We studied electrical brain activity and GABAA mediated mechanisms of B6J.Cg-Gamt(tm1Isb) mice. Electrocorticographic (ECoG) monitoring of pharmacological treatments with ornithine (5 % in drinking water for 5-18 days) and/or Picrotoxin (PTX) (a GABAA receptor antagonist) (1.5 mg/kg, I.P.) in Gamt(MUT) and Gamt(WT) groups [n = 3, mean age (SEM) = 6.9 (0.2) weeks]. Mice were fitted with two frontal and two parietal epidural electrodes under ketamine/xylazine anesthesia. Baseline and test recordings were performed for determination of seizure activity over a 2 h period. The ECoG baseline of Gamt(MUT) exhibited an abnormal monotonous cortical rhythm (7-8 Hz) with little variability during awake and sleep states compared to wild type recordings. Ornithine treatment and also PTX administration led to a relative normalization of the Gamt(MUT) ECoG phenotype. Gamt(WT) on PTX exhibited electro-behavioral seizures, whereas the Gamt(MUT) did not have PTX induced seizures at the same PTX dose. Gamt(MUT) treated with both ornithine and PTX did not show electro-behavioral seizures while ornithine elevated the PTX seizure threshold of Gamt(MUT) mice even further. These data demonstrate: (1) that there is expression of electrical seizure activity in this Gamt-deficient transgenic mouse strain, and (2) that the systemic availability of guanidinoacetate affects GABAA receptor function and seizure thresholds. These findings are directly and clinically relevant for patients with a creatine-deficiency syndrome due to genetic defects in GAMT and provide a rational basis for a combined ornithine/picrotoxin therapeutic intervention.
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Affiliation(s)
- A Schulze
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
| | - C Tran
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.,Center for Molecular Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - V Levandovskiy
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - V Patel
- Program of Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - M A Cortez
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada.,Program of Brain and Behavior Neuroscience and Mental Health, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
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New insights into the trophic and cytoprotective effects of creatine in in vitro and in vivo models of cell maturation. Amino Acids 2016; 48:1897-911. [DOI: 10.1007/s00726-015-2161-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 12/17/2015] [Indexed: 12/19/2022]
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34
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Schulze A, Bauman M, Tsai ACH, Reynolds A, Roberts W, Anagnostou E, Cameron J, Nozzolillo AA, Chen S, Kyriakopoulou L, Scherer SW, Loh A. Prevalence of Creatine Deficiency Syndromes in Children With Nonsyndromic Autism. Pediatrics 2016; 137:peds.2015-2672. [PMID: 26684475 DOI: 10.1542/peds.2015-2672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Creatine deficiency may play a role in the neurobiology of autism and may represent a treatable cause of autism. The goal of the study was to ascertain the prevalence of creatine deficiency syndromes (CDSs) in children with autism spectrum disorder (ASD). METHODS In a prospective multicenter study, 443 children were investigated after a confirmed diagnosis of ASD. Random spot urine screening for creatine metabolites (creatine, guanidinoacetate, creatinine, and arginine) with liquid chromatography-tandem mass spectrometry and second-tier testing with high-performance liquid chromatography methodology was followed by recall testing in 24-hour urines and confirmatory testing by Sanger-based DNA sequencing of GAMT, GATM, and SLC6A8 genes. Additional diagnostic tests included plasma creatine metabolites and in vivo brain proton magnetic resonance spectroscopy. The creatine metabolites in spot urine in the autism group were compared with 128 healthy controls controlled for age. RESULTS In 443 subjects with ASD investigated for CDS, we had 0 events (event: 0, 95% confidence interval 0-0.0068), therefore with 95% confidence the prevalence of CDS is <7 in 1000 children with ASD. The autism and control groups did not vary in terms of creatine metabolites (P > .0125) in urine. CONCLUSION Our study revealed a very low prevalence of CDS in children with nonsyndromic ASD and no obvious association between creatine metabolites and autism. Unlike our study population, we expect more frequent CDS among children with severe developmental delay, speech impairment, seizures, and movement disorders in addition to impairments in social communication, restricted interests, and repetitive behaviors.
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Affiliation(s)
- Andreas Schulze
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, Ontario, Canada; Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Ontario, Canada;
| | - Margaret Bauman
- Lurie Center for Autism, MassGeneral Hospital, Boston, Massachusetts; Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Anne Chun-Hui Tsai
- Colorado University Medical School, Aurora, Colorado; Molecular and Medical Genetics, Oregon Health and Sciences University, Portland, Oregon
| | - Ann Reynolds
- Colorado University Medical School, Aurora, Colorado
| | - Wendy Roberts
- Department of Paediatrics, University of Toronto, Ontario, Canada; Holland Bloorview Kids Rehabilitation, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Department of Paediatrics, University of Toronto, Ontario, Canada; Holland Bloorview Kids Rehabilitation, Toronto, Ontario, Canada
| | - Jessie Cameron
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, Ontario, Canada
| | - Alixandra A Nozzolillo
- Clinical and Translational Science Center, Harvard Medical School, Boston, Massachusetts
| | - Shiyi Chen
- Clinical Research Services, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lianna Kyriakopoulou
- Department of Paediatric Laboratory Medicine, Biochemical Genetics Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen W Scherer
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning, Toronto, Ontario, Canada; The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Molecular Genetics and McLaughlin Centre, University of Toronto, Ontario, Canada
| | - Alvin Loh
- Department of Paediatrics, University of Toronto, Ontario, Canada; Surrey Place Center, Toronto, Ontario, Canada
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Cellular bioenergetics of guanidinoacetic acid: the role of mitochondria. J Bioenerg Biomembr 2015; 47:369-72. [PMID: 26255041 DOI: 10.1007/s10863-015-9619-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 07/31/2015] [Indexed: 10/23/2022]
Abstract
Guanidinoacetic acid (GAA) is a natural precursor of creatine, and a possible substrate for the creatine kinase (CK) enzyme system, serving as a creatine mimetic. Its direct role in cellular bioenergetics has been confirmed in several studies, however GAA utilization by CK seems to be a second-rate as compared to creatine, and compartment-dependent. Here we discuss various factors that might affect GAA use in high-energy phosphoryl transfer in the cytosol and mitochondria.
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36
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Diagnostic Yield of Chromosomal Microarray Analysis in a Cohort of Patients with Autism Spectrum Disorders from a Highly Consanguineous Population. J Autism Dev Disord 2015; 45:2323-8. [DOI: 10.1007/s10803-015-2394-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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