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Liu J, Ni W, Deng K, Chen Y, Gu G. The presence of white cell Jordan's anomaly in multiple Acyl-CoA dehydrogenase deficiency: A case report and implications for clinical practice. Clin Biochem 2024; 125:110735. [PMID: 38401771 DOI: 10.1016/j.clinbiochem.2024.110735] [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: 11/04/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Multiple Acyl-CoA Dehydrogenase Deficiency (MADD), also known as Glutaric Aciduria Type II, is an exceptionally rare autosomal recessive genetic disorder that disrupts the metabolism of fatty acids, amino acids, and choline. It presents with a wide range of clinical manifestations, from severe neonatal-onset forms to milder late-onset cases, with symptoms including metabolic disturbances and muscle weakness. Jordan's anomaly is a distinctive morphological feature found in peripheral blood white cells and is typically associated with Neutral Lipid Storage Disease (NLSD). CASE REPORT In our case report, the patient initially presented with symptoms of vomiting, abdominal pain, and altered consciousness. The presence of white cell Jordan's anomaly was detected in the blood smear. Subsequent serum tests revealed elevated levels of transaminases, creatine kinase, uric acid, and multiple acylcarnitines, while blood glucose and free carnitine levels were notably reduced. High-throughput sequencing confirmed heterozygous pathogenic variants in the electron-transferring flavoprotein dehydrogenase (ETFDH) gene, leading to the conclusive diagnosis of MADD. Following a three-month treatment regimen involving high-dose vitamin B2, coenzyme Q10, and other supportive interventions, the patient exhibited significant clinical improvement, ultimately resulting in discharge. CONCLUSION The identification of Jordan's anomaly in a pediatric patient with late-onset MADD sheds light on its broader implications within the realm of lipid storage myopathies. The significance of this finding extends beyond its conventional association with NLSD, challenging the notion of its exclusivity. This novel observation serves as a compelling reminder of the diagnostic significance this morphological abnormality holds, potentially revolutionizing diagnostic practices within the field.
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Affiliation(s)
- Ji Liu
- Clinical Laboratory, Boai Hospital of Zhongshan, Zhongshan, Guangdong, 528402, PR China
| | - Wenpeng Ni
- Clinical Laboratory, Boai Hospital of Zhongshan, Zhongshan, Guangdong, 528402, PR China.
| | - Kunyi Deng
- Clinical Laboratory, Boai Hospital of Zhongshan, Zhongshan, Guangdong, 528402, PR China
| | - Yanhui Chen
- Clinical Laboratory, Boai Hospital of Zhongshan, Zhongshan, Guangdong, 528402, PR China
| | - Guanghong Gu
- Clinical Laboratory, Zhongshan Torch Development Zone People's Hospital, Zhongshan, Guangdong Province, 528437, 528436, PR China.
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2
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Schwantje M, Mosegaard S, Knottnerus SJG, van Klinken JB, Wanders RJ, van Lenthe H, Hermans J, IJlst L, Denis SW, Jaspers YRJ, Fuchs SA, Houtkooper RH, Ferdinandusse S, Vaz FM. Tracer-based lipidomics enables the discovery of disease-specific candidate biomarkers in mitochondrial β-oxidation disorders. FASEB J 2024; 38:e23478. [PMID: 38372965 DOI: 10.1096/fj.202302163r] [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: 10/23/2023] [Revised: 01/05/2024] [Accepted: 01/26/2024] [Indexed: 02/20/2024]
Abstract
Carnitine derivatives of disease-specific acyl-CoAs are the diagnostic hallmark for long-chain fatty acid β-oxidation disorders (lcFAOD), including carnitine shuttle deficiencies, very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD), long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) and mitochondrial trifunctional protein deficiency (MPTD). The exact consequence of accumulating lcFAO-intermediates and their influence on cellular lipid homeostasis is, however, still unknown. To investigate the fate and cellular effects of the accumulating lcFAO-intermediates and to explore the presence of disease-specific markers, we used tracer-based lipidomics with deuterium-labeled oleic acid (D9-C18:1) in lcFAOD patient-derived fibroblasts. In line with previous studies, we observed a trend towards neutral lipid accumulation in lcFAOD. In addition, we detected a direct connection between the chain length and patterns of (un)saturation of accumulating acylcarnitines and the various enzyme deficiencies. Our results also identified two disease-specific candidate biomarkers. Lysophosphatidylcholine(14:1) (LPC(14:1)) was specifically increased in severe VLCADD compared to mild VLCADD and control samples. This was confirmed in plasma samples showing an inverse correlation with enzyme activity, which was better than the classic diagnostic marker C14:1-carnitine. The second candidate biomarker was an unknown lipid class, which we identified as S-(3-hydroxyacyl)cysteamines. We hypothesized that these were degradation products of the CoA moiety of accumulating 3-hydroxyacyl-CoAs. S-(3-hydroxyacyl)cysteamines were significantly increased in LCHADD compared to controls and other lcFAOD, including MTPD. Our findings suggest extensive alternative lipid metabolism in lcFAOD and confirm that lcFAOD accumulate neutral lipid species. In addition, we present two disease-specific candidate biomarkers for VLCADD and LCHADD, that may have significant relevance for disease diagnosis, prognosis, and monitoring.
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Affiliation(s)
- Marit Schwantje
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Signe Mosegaard
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, Amsterdam, the Netherlands
| | - Suzan J G Knottnerus
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
| | - Jan Bert van Klinken
- Core Facility Metabolomics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Ronald J Wanders
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
| | - Henk van Lenthe
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jill Hermans
- Core Facility Metabolomics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Lodewijk IJlst
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
| | - Simone W Denis
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Yorrick R J Jaspers
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Core Facility Metabolomics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sabine A Fuchs
- Department of Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Riekelt H Houtkooper
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sacha Ferdinandusse
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
| | - Frédéric M Vaz
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, Amsterdam, the Netherlands
- Core Facility Metabolomics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Rouyer A, Tard C, Dessein A, Spinazzi M, Bédat‐Millet A, Dimitri‐Boulos D, Nadaj‐Pakleza A, Chanson J, Nicolas G, Douillard C, Laforêt P. Long-term prognosis of fatty-acid oxidation disorders in adults: Optimism despite the limited effective therapies available. Eur J Neurol 2024; 31:e16138. [PMID: 38015438 PMCID: PMC11235989 DOI: 10.1111/ene.16138] [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: 06/09/2023] [Revised: 09/25/2023] [Accepted: 10/21/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Fatty-acid oxidation disorders (FAODs) are recessive genetic diseases. MATERIALS AND METHODS We report here clinical and paraclinical data from a retrospective study of 44 adults with muscular FAODs from six French reference centers for neuromuscular or metabolic diseases. RESULTS The study cohort consisted of 44 adult patients: 14 with carnitine palmitoyl transferase 2 deficiency (32%), nine with multiple acyl-CoA deficiency (20%), 13 with very long-chain acyl-CoA dehydrogenase deficiency (30%), three with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (7%), and five with short-chain acyl-CoA dehydrogenase deficiency (11%). Disease onset occurred during childhood in the majority of patients (59%), with a mean age at onset of 15 years (range = 0.5-35) and a mean of 12.6 years (range = 0-58) from disease onset to diagnosis. The principal symptoms were acute muscle manifestations (rhabdomyolysis, exercise intolerance, myalgia), sometimes associated with permanent muscle weakness. Episodes of rhabdomyolysis were frequent (84%), with a mean creatinine kinase level of 68,958 U/L (range = 660-300,000). General metabolic complications were observed in 58% of patients, respiratory manifestations in 18% of cases, and cardiological manifestations in 9% of cases. Fasting acylcarnitine profile was used to orient genetic explorations in 65% of cases. After a mean follow-up of 10 years, 33% of patients were asymptomatic and 56% continued to display symptoms after exercise. The frequency of rhabdomyolysis decreased after diagnosis in 64% of cases. CONCLUSION A standardized register would complete this cohort description of muscular forms of FAODs with exhaustive data, making it possible to assess the efficacy of therapeutic protocols in real-life conditions and during the long-term follow-up of patients.
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Affiliation(s)
- Alice Rouyer
- Neurology DepartmentRaymond Poincaré University Hospital, Assitance Publique des Hopitaux de ParisGarchesFrance
| | - Céline Tard
- Neurology Department, University of Lille, Inserm, Centre Hospialo‐Niversitaire Lille, U1172–LilNCog (JPARC)–Lille Neuroscience and CognitionNord‐Est‐Ile‐de‐France Neuromuscular Reference Center, Cognitive‐Motor Unit of Expertise, Centre Hospitalo‐Régional Universitaire LilleLilleFrance
| | - Anne‐Frédérique Dessein
- Institute of Biochemistry, Biology, and Pathology Center, Metabolism Department and Medical Reference Center for Inherited Metabolic DiseasesLille University HospitalLilleFrance
| | - Marco Spinazzi
- Department of Neurology, Neuromuscular Reference Center Atlantique Occitanie CaraïbeUniversity HospitalAngersFrance
| | | | - Dalia Dimitri‐Boulos
- Internal Medicine DepartmentQuinze‐Vingts National Ophthalmology HospitalParisFrance
| | - Aleksandra Nadaj‐Pakleza
- Department of Neurology, Reference Center for Neuromuscular Disorders Nord‐Est‐Ile‐de‐France, European Reference Network for Rare Neuromuscular DiseasesUniversity Hospital of StrasbourgStrasbourgFrance
| | - Jean‐Baptiste Chanson
- Department of Neurology, Reference Center for Neuromuscular Disorders Nord‐Est‐Ile‐de‐France, European Reference Network for Rare Neuromuscular DiseasesUniversity Hospital of StrasbourgStrasbourgFrance
| | - Guillaume Nicolas
- Neurology DepartmentRaymond Poincaré University Hospital, Assitance Publique des Hopitaux de ParisGarchesFrance
- Nord‐Est‐Ile‐de‐France Neuromuscular Reference CenterFédération Hospitalo‐Universitaire PHENIXGarchesFrance
- U 1179 INSERMParis‐Saclay UniversityMontigny‐le‐BretonneuxFrance
| | - Claire Douillard
- Endocrinology–Diabetology–Metabolism Department and Medical Reference Center for Inherited Metabolic Diseases Jeanne de Flandre Hospital, Centre Hospitalo‐Régional Universitaire LilleLilleFrance
| | - Pascal Laforêt
- Neurology DepartmentRaymond Poincaré University Hospital, Assitance Publique des Hopitaux de ParisGarchesFrance
- Nord‐Est‐Ile‐de‐France Neuromuscular Reference CenterFédération Hospitalo‐Universitaire PHENIXGarchesFrance
- U 1179 INSERMParis‐Saclay UniversityMontigny‐le‐BretonneuxFrance
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4
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Bhai SF, Vissing J. Diagnosis and management of metabolic myopathies. Muscle Nerve 2023; 68:250-256. [PMID: 37226557 DOI: 10.1002/mus.27840] [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: 01/19/2023] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 05/26/2023]
Abstract
Metabolic myopathies are a set of rare inborn errors of metabolism leading to disruption in energy production. Relevant to skeletal muscle, glycogen storage disease and fatty acid oxidation defects can lead to exercise intolerance, rhabdomyolysis, and weakness in children and adults, distinct from the severe forms that involve multiple-organ systems. These nonspecific, dynamic symptoms along with conditions that mimic metabolic myopathies can make diagnosis challenging. Clinicians can shorten the time to diagnosis by recognizing the typical clinical phenotypes and performing next generation sequencing. With improved access and affordability of molecular testing, clinicians need to be well-versed in resolving variants of uncertain significance relevant to metabolic myopathies. Once identified, patients can improve quality of life, safely engage in exercise, and reduce episodes of rhabdomyolysis by modifying diet and lifestyle habits.
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Affiliation(s)
- Salman F Bhai
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Neuromuscular Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas, USA
| | - John Vissing
- Department of Neurology, Rigshospitalet, Copenhagen Neuromuscular Center, University of Copenhagen, Copenhagen, Denmark
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5
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Angelini C, Burlina A, Blau N, Ferreira CR. Clinical and biochemical footprints of inherited metabolic disorders: X. Metabolic myopathies. Mol Genet Metab 2022; 137:213-222. [PMID: 36155185 PMCID: PMC10507680 DOI: 10.1016/j.ymgme.2022.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
Metabolic myopathies are characterized by the deficiency or dysfunction of essential metabolites or fuels to generate energy for muscle contraction; they most commonly manifest with neuromuscular symptoms due to impaired muscle development or functioning. We have summarized associations of signs and symptoms in 358 inherited metabolic diseases presenting with myopathies. This represents the tenth of a series of articles attempting to create and maintain a comprehensive list of clinical and metabolic differential diagnoses according to system involvement.
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Affiliation(s)
- Corrado Angelini
- Laboratory for Neuromuscular Diseases, Campus Pietro d'Abano, University of Padova, Padova, Italy.
| | - Alberto Burlina
- Division of Inherited Metabolic Diseases, Reference Center for Expanded Newborn Screening, University Hospital Padova, 35128, Padua, Italy.
| | - Nenad Blau
- Division of Metabolism, University Children's Hospital, Zürich, Switzerland.
| | - Carlos R Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
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6
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Marra F, Lunetti P, Curcio R, Lasorsa FM, Capobianco L, Porcelli V, Dolce V, Fiermonte G, Scarcia P. An Overview of Mitochondrial Protein Defects in Neuromuscular Diseases. Biomolecules 2021; 11:1633. [PMID: 34827632 PMCID: PMC8615828 DOI: 10.3390/biom11111633] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
Neuromuscular diseases (NMDs) are dysfunctions that involve skeletal muscle and cause incorrect communication between the nerves and muscles. The specific causes of NMDs are not well known, but most of them are caused by genetic mutations. NMDs are generally progressive and entail muscle weakness and fatigue. Muscular impairments can differ in onset, severity, prognosis, and phenotype. A multitude of possible injury sites can make diagnosis of NMDs difficult. Mitochondria are crucial for cellular homeostasis and are involved in various metabolic pathways; for this reason, their dysfunction can lead to the development of different pathologies, including NMDs. Most NMDs due to mitochondrial dysfunction have been associated with mutations of genes involved in mitochondrial biogenesis and metabolism. This review is focused on some mitochondrial routes such as the TCA cycle, OXPHOS, and β-oxidation, recently found to be altered in NMDs. Particular attention is given to the alterations found in some genes encoding mitochondrial carriers, proteins of the inner mitochondrial membrane able to exchange metabolites between mitochondria and the cytosol. Briefly, we discuss possible strategies used to diagnose NMDs and therapies able to promote patient outcome.
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Affiliation(s)
- Federica Marra
- Department of Pharmacy, Health, and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (F.M.); (R.C.); (V.D.)
| | - Paola Lunetti
- Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy; (P.L.); (L.C.)
| | - Rosita Curcio
- Department of Pharmacy, Health, and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (F.M.); (R.C.); (V.D.)
| | - Francesco Massimo Lasorsa
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, via E. Orabona 4, 70125 Bari, Italy; (F.M.L.); (V.P.)
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, National Research Council, 00155 Rome, Italy
| | - Loredana Capobianco
- Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy; (P.L.); (L.C.)
| | - Vito Porcelli
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, via E. Orabona 4, 70125 Bari, Italy; (F.M.L.); (V.P.)
| | - Vincenza Dolce
- Department of Pharmacy, Health, and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (F.M.); (R.C.); (V.D.)
| | - Giuseppe Fiermonte
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, via E. Orabona 4, 70125 Bari, Italy; (F.M.L.); (V.P.)
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, National Research Council, 00155 Rome, Italy
| | - Pasquale Scarcia
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, via E. Orabona 4, 70125 Bari, Italy; (F.M.L.); (V.P.)
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Tang H, Cui M, Han M. Fatty acids impact sarcomere integrity through myristoylation and ER homeostasis. Cell Rep 2021; 36:109539. [PMID: 34407398 PMCID: PMC8404530 DOI: 10.1016/j.celrep.2021.109539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/04/2021] [Accepted: 07/26/2021] [Indexed: 01/01/2023] Open
Abstract
Decreased ability to maintain tissue integrity is critically involved in aging and degenerative diseases. Fatty acid (FA) metabolism has a profound impact on animal development and tissue maintenance, but our understanding of the underlying mechanisms is limited. We investigated whether and how FA abundance affects muscle integrity using Caenorhabditis elegans. We show that reducing the overall FA level by blocking FA biosynthesis or inhibiting protein myristoylation leads to disorganization of sarcomere structure and adult-onset paralysis. Further analysis indicates that myristoylation of two ARF guanosine triphosphatases (GTPases) critically mediates the effect of FA deficiency on sarcomere integrity through inducing endoplasmic reticulum (ER) stress and ER unfolded protein response (UPRER), which in turn leads to reduction of the level of sarcomere component PINCH and myosin disorganization. We thus present a mechanism that links FA signal, protein myristoylation, and ER homeostasis with muscle integrity, which provides valuable insights into the regulatory role of nutrients and ER homeostasis in muscle maintenance.
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Affiliation(s)
- Hongyun Tang
- Department of MCDB, University of Colorado Boulder, Boulder, CO 80309, USA; Key Laboratory of Growth Regulation and Transformation Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, Zhejiang Province, China; Institute of Biology, Westlake Institute for Advanced Study, 18 Shilongshan Road, Hangzhou 310024, Zhejiang Province, China
| | - Mingxue Cui
- Department of MCDB, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Min Han
- Department of MCDB, University of Colorado Boulder, Boulder, CO 80309, USA.
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Inherited Neuromuscular Disorders: Which Role for Serum Biomarkers? Brain Sci 2021; 11:brainsci11030398. [PMID: 33801069 PMCID: PMC8004068 DOI: 10.3390/brainsci11030398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 12/12/2022] Open
Abstract
Inherited neuromuscular disorders (INMD) are a heterogeneous group of rare diseases that involve muscles, motor neurons, peripheral nerves or the neuromuscular junction. Several different lab abnormalities have been linked to INMD: sometimes they are typical of the disorder, but they usually appear to be less specific. Sometimes serum biomarkers can point out abnormalities in presymtomatic or otherwise asymptomatic patients (e.g., carriers). More often a biomarker of INMD is evaluated by multiple clinicians other than expert in NMD before the diagnosis, because of the multisystemic involvement in INMD. The authors performed a literature search on biomarkers in inherited neuromuscular disorders to provide a practical approach to the diagnosis and the correct management of INMD. A considerable number of biomarkers have been reported that support the diagnosis of INMD, but the role of an expert clinician is crucial. Hence, the complete knowledge of such abnormalities can accelerate the diagnostic workup supporting the referral to specialists in neuromuscular disorders.
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Potential Role of L-Carnitine in Autism Spectrum Disorder. J Clin Med 2021; 10:jcm10061202. [PMID: 33805796 PMCID: PMC8000371 DOI: 10.3390/jcm10061202] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
L-carnitine plays an important role in the functioning of the central nervous system, and especially in the mitochondrial metabolism of fatty acids. Altered carnitine metabolism, abnormal fatty acid metabolism in patients with autism spectrum disorder (ASD) has been documented. ASD is a complex heterogeneous neurodevelopmental condition that is usually diagnosed in early childhood. Patients with ASD require careful classification as this heterogeneous clinical category may include patients with an intellectual disability or high functioning, epilepsy, language impairments, or associated Mendelian genetic conditions. L-carnitine participates in the long-chain oxidation of fatty acids in the brain, stimulates acetylcholine synthesis (donor of the acyl groups), stimulates expression of growth-associated protein-43, prevents cell apoptosis and neuron damage and stimulates neurotransmission. Determination of L-carnitine in serum/plasma and analysis of acylcarnitines in a dried blood spot may be useful in ASD diagnosis and treatment. Changes in the acylcarnitine profiles may indicate potential mitochondrial dysfunctions and abnormal fatty acid metabolism in ASD children. L-carnitine deficiency or deregulation of L-carnitine metabolism in ASD is accompanied by disturbances of other metabolic pathways, e.g., Krebs cycle, the activity of respiratory chain complexes, indicative of mitochondrial dysfunction. Supplementation of L-carnitine may be beneficial to alleviate behavioral and cognitive symptoms in ASD patients.
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10
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Angelini C, Marozzo R, Pegoraro V, Sacconi S. Diagnostic challenges in metabolic myopathies. Expert Rev Neurother 2020; 20:1287-1298. [PMID: 32941087 DOI: 10.1080/14737175.2020.1825943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Metabolic myopathies comprise a clinically etiological diverse group of disorders caused by defects in cellular energy metabolism including the breakdown of carbohydrates and fatty acids, which include glycogen storage diseases and fatty acid oxidation disorders. Their wide clinical spectrum ranges from infantile severe multisystemic disorders to adult-onset myopathies. To suspect in adults these disorders, clinical features such as exercise intolerance and recurrent myoglobinuria need investigation while another group presents fixed weakness and cardiomyopathy as a clinical pattern. AREAS COVERED In metabolic myopathies, clinical manifestations are important to guide diagnostic tests used in order to lead to the correct diagnosis. The authors searched in literature the most recent techniques developed. The authors present an overview of the most common phenotypes of Pompe disease and what is currently known about the mechanism of ERT treatment. The most common disorders of lipid metabolism are overviewed, with their possible dietary or supplementary treatments. EXPERT COMMENTARY The clinical suspicion is the clue to conduct in-depth investigations in suspected cases of metabolic myopathies that lead to the final diagnosis with biochemical molecular studies and often nowadays by the use of Next Generation Sequencing (NGS) to determine gene mutations.
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Affiliation(s)
- Corrado Angelini
- Neuromuscular Center, IRCCS San Camillo Hospital , Venice, Italy
| | - Roberta Marozzo
- Neuromuscular Center, IRCCS San Camillo Hospital , Venice, Italy
| | | | - Sabrina Sacconi
- Peripheral Nervous System and Muscle Department, Université Cote d'Azur, CHU , Nice, France
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Saito Y, Nishikawa A, Iida A, Mori-Yoshimura M, Oya Y, Ishiyama A, Komaki H, Nakamura S, Fujikawa S, Kanda T, Yamadera M, Sakiyama H, Hayashi S, Nonaka I, Noguchi S, Nishino I. ADSSL1 myopathy is the most common nemaline myopathy in Japan with variable clinical features. Neurology 2020; 95:e1500-e1511. [DOI: 10.1212/wnl.0000000000010237] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/17/2020] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo elucidate the prevalence of Japanese ADSSL1 myopathy and determine the clinicopathologic features of the disease.MethodsWe searched forADSSL1variants in myopathic patients from January 1978 to March 2019 in our repository and assessed the clinicopathologic features of patients with variants.ResultsWe identified 63 patients from 59 families with biallelic variants ofADSSL1. Among the 7 distinct variants identified, c.781G>A and c.919delA accounted for 53.2% and 40.5% of alleles, respectively, suggesting the presence of common founders, while the other 5 were novel. Most of the identified patients displayed more variable muscle symptoms, including symptoms in the proximal and/or distal leg muscles, tongue, masseter, diaphragm, and paraspinal muscles, in adolescence than previously reported patients. Dysphagia with masticatory dysfunction developed in 26 out of 63 patients; hypertrophic cardiomyopathy developed in 12 out of 48 patients; and restrictive ventilatory insufficiency developed in 26 out of 34 patients in later stages. Radiologically, fat infiltration into the periphery of vastus lateralis, gastrocnemius, and soleus muscles was observed in all patients. Pathologically, nemaline bodies in addition to increased lipid droplets and myofibrillar disorganization were commonly observed in all patients, suggesting that the disease may be classified as nemaline myopathy. This finding revealed thatADSSL1myopathy is the most frequent among all genetically diagnosable nemaline myopathies in our center.ConclusionsADSSL1 myopathy is characterized by more variable manifestations than previously reported. It is the most common among all genetically diagnosable nemaline myopathies in our center, although mildly increased lipid droplets are also constantly observed features.
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Samukawa M, Nakamura N, Hirano M, Morikawa M, Sakata H, Nishino I, Izumi R, Suzuki N, Kuroda H, Shiga K, Saigoh K, Aoki M, Kusunoki S. Neutral Lipid Storage Disease Associated with the PNPLA2 Gene: Case Report and Literature Review. Eur Neurol 2020; 83:317-322. [PMID: 32564019 DOI: 10.1159/000508346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 04/20/2020] [Indexed: 11/19/2022]
Abstract
Mutations in the PNPLA2 gene cause neutral lipid storage disease with myopathy (NLSDM) or triglyceride deposit cardiomyovasculopathy. We report a detailed case study of a 53-year-old man with NLSDM. The PNPLA2 gene was analyzed according to the reported method. We summarized the clinical, laboratory, and genetic information of 56 patients, including our patient and 55 other reported patients with homozygous or compound heterozygous mutations in the PNPLA2 gene. We found a novel homozygous mutation (c.194delC) in the PNPLA2 gene that resulted in frameshift. The patient suffered from normal-tension glaucoma and pulmonary cysts, symptoms that are relatively common in the elderly but were not previously reported for this disease. Our summary confirmed that Jordan's anomaly, polymorphonuclear leukocytes with lipid accumulation, was the most consistent finding of this disease. Because this disease is potentially treatable, our results may help rapid and correct diagnosis.
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Affiliation(s)
- Makoto Samukawa
- Department of Neurology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Naoko Nakamura
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Makito Hirano
- Department of Neurology, Kindai University, Faculty of Medicine, Osaka, Japan,
| | - Miyuki Morikawa
- Department of Neurology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Hanami Sakata
- Department of Neurology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Rumiko Izumi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoki Suzuki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Kuroda
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kensuke Shiga
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Neurology, Matsushita Memorial Hospital, Osaka, Japan
| | - Kazumasa Saigoh
- Department of Neurology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Susumu Kusunoki
- Department of Neurology, Kindai University, Faculty of Medicine, Osaka, Japan
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Joshi PR, Zierz S. Muscle Carnitine Palmitoyltransferase II (CPT II) Deficiency: A Conceptual Approach. Molecules 2020; 25:molecules25081784. [PMID: 32295037 PMCID: PMC7221885 DOI: 10.3390/molecules25081784] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/08/2020] [Accepted: 04/11/2020] [Indexed: 11/16/2022] Open
Abstract
Carnitine palmitoyltransferase (CPT) catalyzes the transfer of long- and medium-chain fatty acids from cytoplasm into mitochondria, where oxidation of fatty acids takes place. Deficiency of CPT enzyme is associated with rare diseases of fatty acid metabolism. CPT is present in two subforms: CPT I at the outer mitochondrial membrane and carnitine palmitoyltransferase II (CPT II) inside the mitochondria. Deficiency of CPT II results in the most common inherited disorder of long-chain fatty acid oxidation affecting skeletal muscle. There is a lethal neonatal form, a severe infantile hepato-cardio-muscular form, and a rather mild myopathic form characterized by exercise-induced myalgia, weakness, and myoglobinuria. Total CPT activity (CPT I + CPT II) in muscles of CPT II-deficient patients is generally normal. Nevertheless, in some patients, not detectable to reduced total activities are also reported. CPT II protein is also shown in normal concentration in patients with normal CPT enzymatic activity. However, residual CPT II shows abnormal inhibition sensitivity towards malonyl-CoA, Triton X-100 and fatty acid metabolites in patients. Genetic studies have identified a common p.Ser113Leu mutation in the muscle form along with around 100 different rare mutations. The biochemical consequences of these mutations have been controversial. Hypotheses include lack of enzymatically active protein, partial enzyme deficiency and abnormally regulated enzyme. The recombinant enzyme experiments that we recently conducted have shown that CPT II enzyme is extremely thermoliable and is abnormally inhibited by different emulsifiers and detergents such as malonyl-CoA, palmitoyl-CoA, palmitoylcarnitine, Tween 20 and Triton X-100. Here, we present a conceptual overview on CPT II deficiency based on our own findings and on results from other studies addressing clinical, biochemical, histological, immunohistological and genetic aspects, as well as recent advancements in diagnosis and therapeutic strategies in this disorder.
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Nadjar Y, Souvannanorath S, Maisonobe T, Brisset M, De Lonlay P, Schiff M, Viala K, Boutron A, Nicolas G, Laforêt P. Sensory neuronopathy as a major clinical feature of mitochondrial trifunctional protein deficiency in adults. Rev Neurol (Paris) 2020; 176:380-386. [PMID: 32253025 DOI: 10.1016/j.neurol.2019.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/22/2019] [Accepted: 11/07/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Mitochondrial trifunctional protein deficiency (MTPD) is a long-chain fatty acid oxidation disorder characterized by co-existence of rhabdomyolysis episodes and peripheral neuropathy. Two phenotypes are described: generalized mitochondrial trifunctional protein deficiency (gMTPD) and isolated long-chain-3-hydroxyacyl-CoA dehydrogenase deficiency (iLCHADD) that is always associated with the c.1528G>C mutation. Peripheral neuropathy of MTPD is commonly described in children as axonal, length-dependent and sensorimotor. OBJECTIVES To report clinical and electrophysiological features of four independent adult MTPD patients with peripheral neuropathy. RESULTS Onset of the disease was characterized in all patients by rhabdomyolysis episodes occurring during childhood preceded by severe hypoglycemic episodes in three patients. Peripheral nerve involvement manifesting as sensory ataxia appeared later, during adolescence or adulthood. In all cases, electroneuromyogram showed no length-dependent sensory potentials decrease characteristic of sensory neuronopathy ("ganglionopathy"). All patients harbored at least one c.1528G>C mutation. DISCUSSION We describe MTPD as a newly hereditary etiology of sensory neuronopathy in adults, specifically in patients with c.1528G>C mutation. MTPD should be screened for by performing plasma acylcarnitines in patients with chronic sensory neuronopathy and additional suggestive features such as exercise intolerance or retinopathy.
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Affiliation(s)
- Y Nadjar
- Département de neurologie, centre de référence des maladies lysosomales, UF neuro-génétique et métabolisme, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - S Souvannanorath
- Centre de référence des maladies neuromusculaires, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Pars, Créteil, France.
| | - T Maisonobe
- Département de neurophysiologie clinique, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - M Brisset
- Département de neurologie, hôpital Raymond-Poincaré, Garches, France; Inserm U1179 Versailles Saint-Quentin-en-Yvelines university, 78180 Montigny-le-Bretonneux, France.
| | - P De Lonlay
- Reference center for inborn errors of metabolism, Necker-Enfants-Malades university hospital, AP-HP, Paris Descartes university, INSERM UMR_S1151, 75015 Paris, France.
| | - M Schiff
- Reference center for inborn errors of metabolism, Robert-Debré university hospital, AP-HP, Paris Diderot university, INSERM U1141, 75019 Paris, France.
| | - K Viala
- Département de neurophysiologie clinique, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - A Boutron
- Service de biochimie, hôpital de Bicêtre, CHU Paris - GH Paris-Sud, Paris, France.
| | - G Nicolas
- Département de neurologie, hôpital Raymond-Poincaré, Garches, France; Inserm U1179 Versailles Saint-Quentin-en-Yvelines university, 78180 Montigny-le-Bretonneux, France.
| | - P Laforêt
- Département de neurologie, hôpital Raymond-Poincaré, Garches, France; Inserm U1179 Versailles Saint-Quentin-en-Yvelines university, 78180 Montigny-le-Bretonneux, France.
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Angelini C, Pennisi E, Missaglia S, Tavian D. Metabolic lipid muscle disorders: biomarkers and treatment. Ther Adv Neurol Disord 2019; 12:1756286419843359. [PMID: 31040882 PMCID: PMC6477769 DOI: 10.1177/1756286419843359] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/08/2019] [Indexed: 12/21/2022] Open
Abstract
Lipid storage myopathies (LSMs) are metabolic disorders of the utilization of fat in muscles due to several different defects. In this review, a molecular update of LSMs is presented and recent attempts of finding treatment options are discussed. The main topics discussed are: primary carnitine deficiency, riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency, neutral lipid storage disorders and carnitine palmitoyl transferase deficiency. The most frequent presentations and genetic abnormalities are summarized. We present their diagnosis utilizing biomedical and morphological biomarkers and possible therapeutic interventions. The treatment of these metabolic disorders is a subject of active translational research but appears, in some cases, still elusive.
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Affiliation(s)
- Corrado Angelini
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, Venezia 30126, Italia
| | - Elena Pennisi
- Division of Neurology, S Filippo Neri Hospital, Rome, Italy
| | - Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy Psychology Department, Catholic University of the Sacred Heart, Milan, Italy
| | - Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy Psychology Department, Catholic University of the Sacred Heart, Milan, Italy
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Garcia MA, Rojas JA, Millán SP, Flórez AA. Neutral lipid storage disease with myopathy and dropped head syndrome. Report of a new variant susceptible of treatment with late diagnosis. J Clin Neurosci 2018; 58:207-209. [DOI: 10.1016/j.jocn.2018.10.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 10/07/2018] [Indexed: 10/28/2022]
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17
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Pennisi EM, Garibaldi M, Antonini G. Lipid Myopathies. J Clin Med 2018; 7:E472. [PMID: 30477112 PMCID: PMC6306737 DOI: 10.3390/jcm7120472] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 11/15/2018] [Accepted: 11/17/2018] [Indexed: 02/06/2023] Open
Abstract
Disorders of lipid metabolism affect several tissues, including skeletal and cardiac muscle tissues. Lipid myopathies (LM) are rare multi-systemic diseases, which most often are due to genetic defects. Clinically, LM can have acute or chronic clinical presentation. Disease onset can occur in all ages, from early stages of life to late-adult onset, showing with a wide spectrum of clinical symptoms. Muscular involvement can be fluctuant or stable and can manifest as fatigue, exercise intolerance and muscular weakness. Muscular atrophy is rarely present. Acute muscular exacerbations, resulting in rhabdomyolysis crisis are triggered by several factors. Several classifications of lipid myopathies have been proposed, based on clinical involvement, biochemical defect or histopathological findings. Herein, we propose a full revision of all the main clinical entities of lipid metabolism disorders with a muscle involvement, also including some those disorders of fatty acid oxidation (FAO) with muscular symptoms not included among previous lipid myopathies classifications.
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Affiliation(s)
- Elena Maria Pennisi
- Unit of Neuromuscular Disorders, Neurology, San Filippo Neri Hospital, 00135 Rome, Italy.
| | - Matteo Garibaldi
- Unit of Neuromuscular Diseases, Department of Neurology, Mental Health and Sensory Organs (NESMOS), SAPIENZA University of Rome, Sant' Andrea Hospital, 00189 Rome, Italy.
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology, Mental Health and Sensory Organs (NESMOS), SAPIENZA University of Rome, Sant' Andrea Hospital, 00189 Rome, Italy.
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18
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Cortés R, Kleinsteuber K, Paz Vargas C, de Los Ángeles Avaria M. Miopatías metabólicas. REVISTA MÉDICA CLÍNICA LAS CONDES 2018. [DOI: 10.1016/j.rmclc.2018.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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19
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Silva AM, Mendonça RH, Soares DC, Callegaro D, Caldas VM, Perissinotti IN, Carvalho MS, Zanoteli E. Pearls & Oy-sters: A curable myopathy manifesting as exercise intolerance and respiratory failure. Neurology 2018; 91:187-190. [DOI: 10.1212/wnl.0000000000005867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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20
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21
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Guha S, Harikrishnan S, Ray S, Sethi R, Ramakrishnan S, Banerjee S, Bahl VK, Goswami KC, Banerjee AK, Shanmugasundaram S, Kerkar PG, Seth S, Yadav R, Kapoor A, Mahajan AU, Mohanan PP, Mishra S, Deb PK, Narasimhan C, Pancholia AK, Sinha A, Pradhan A, Alagesan R, Roy A, Vora A, Saxena A, Dasbiswas A, Srinivas BC, Chattopadhyay BP, Singh BP, Balachandar J, Balakrishnan KR, Pinto B, Manjunath CN, Lanjewar CP, Jain D, Sarma D, Paul GJ, Zachariah GA, Chopra HK, Vijayalakshmi IB, Tharakan JA, Dalal JJ, Sawhney JPS, Saha J, Christopher J, Talwar KK, Chandra KS, Venugopal K, Ganguly K, Hiremath MS, Hot M, Das MK, Bardolui N, Deshpande NV, Yadava OP, Bhardwaj P, Vishwakarma P, Rajput RK, Gupta R, Somasundaram S, Routray SN, Iyengar SS, Sanjay G, Tewari S, G S, Kumar S, Mookerjee S, Nair T, Mishra T, Samal UC, Kaul U, Chopra VK, Narain VS, Raj V, Lokhandwala Y. CSI position statement on management of heart failure in India. Indian Heart J 2018; 70 Suppl 1:S1-S72. [PMID: 30122238 PMCID: PMC6097178 DOI: 10.1016/j.ihj.2018.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Santanu Guha
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | - S Harikrishnan
- Chief Coordinator, CSI HF Position Statement; Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India.
| | - Saumitra Ray
- Convenor, CSI Guidelines Committee; Vivekananda Institute of Medical Sciences, Kolkata
| | - Rishi Sethi
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow
| | - S Ramakrishnan
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Suvro Banerjee
- Joint Convenor, CSI Guidelines Committee; Apollo Hospitals, Kolkata
| | - V K Bahl
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - K C Goswami
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Amal Kumar Banerjee
- Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
| | - S Shanmugasundaram
- Department of Cardiology, Tamil Nadu Medical University, Billroth Hospital, Chennai, Tamil Nadu, India
| | | | - Sandeep Seth
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Yadav
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Ajaykumar U Mahajan
- Department of Cardiology, LokmanyaTilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - P P Mohanan
- Department of Cardiology, Westfort Hi Tech Hospital, Thrissur, Kerala, India
| | - Sundeep Mishra
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - P K Deb
- Daffodil Hospitals, Kolkata, West Bengal, India
| | - C Narasimhan
- Department of Cardiology & Chief of Electro Physiology Department, Care Hospitals, Hyderabad, Telangana, India
| | - A K Pancholia
- Clinical & Preventive Cardiology, Arihant Hospital & Research Centre, Indore, Madhya Pradesh, India
| | | | - Akshyaya Pradhan
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - R Alagesan
- The Tamil Nadu Dr.M.G.R. Medical University, Tamil Nadu, India
| | - Ambuj Roy
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Amit Vora
- Arrhythmia Associates, Mumbai, Maharashtra, India
| | - Anita Saxena
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - B P Singh
- Department of Cardiology, IGIMS, Patna, Bihar, India
| | | | - K R Balakrishnan
- Cardiac Sciences, Fortis Malar Hospital, Adyar, Chennai, Tamil Nadu, India
| | - Brian Pinto
- Holy Family Hospitals, Mumbai, Maharashtra, India
| | - C N Manjunath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | | | - Dharmendra Jain
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Dipak Sarma
- Cardiology & Critical Care, Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | - G Justin Paul
- Department of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India
| | | | | | - I B Vijayalakshmi
- Bengaluru Medical College and Research Institute, Bengaluru, Karnataka, India
| | - J A Tharakan
- Department of Cardiology, P.K. Das Institute of Medical Sciences, Vaniamkulam, Palakkad, Kerala, India
| | - J J Dalal
- Kokilaben Hospital, Mumbai, Maharshtra, India
| | - J P S Sawhney
- Department of Cardiology, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
| | - Jayanta Saha
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | | | - K K Talwar
- Max Healthcare, Max Super Speciality Hospital, Saket, New Delhi, India
| | - K Sarat Chandra
- Indo-US Super Speciality Hospital & Virinchi Hospital, Hyderabad, Telangana, India
| | - K Venugopal
- Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - Kajal Ganguly
- Department of Cardiology, N.R.S. Medical College, Kolkata, West Bengal, India
| | | | - Milind Hot
- Department of CTVS, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Mrinal Kanti Das
- B.M. Birla Heart Research Centre & CMRI, Kolkata, West Bengal, India
| | - Neil Bardolui
- Department of Cardiology, Excelcare Hospitals, Guwahati, Assam, India
| | - Niteen V Deshpande
- Cardiac Cath Lab, Spandan Heart Institute and Research Center, Nagpur, Maharashtra, India
| | - O P Yadava
- National Heart Institute, New Delhi, India
| | - Prashant Bhardwaj
- Department of Cardiology, Military Hospital (Cardio Thoracic Centre), Pune, Maharashtra, India
| | - Pravesh Vishwakarma
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow
| | | | - Rakesh Gupta
- JROP Institute of Echocardiography, New Delhi, India
| | | | - S N Routray
- Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
| | - S S Iyengar
- Manipal Hospitals, Bangalore, Karnataka, India
| | - G Sanjay
- Chief Coordinator, CSI HF Position Statement; Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | | | - Soumitra Kumar
- Convenor, CSI Guidelines Committee; Vivekananda Institute of Medical Sciences, Kolkata
| | - Soura Mookerjee
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | - Tiny Nair
- Department of Cardiology, P.R.S. Hospital, Trivandrum, Kerala, India
| | - Trinath Mishra
- Department of Cardiology, M.K.C.G. Medical College, Behrampur, Odisha, India
| | | | - U Kaul
- Batra Heart Center & Batra Hospital and Medical Research Center, New Delhi, India
| | - V K Chopra
- Heart Failure Programme, Department of Cardiology, Medanta Medicity, Gurugram, Haryana, India
| | - V S Narain
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow
| | - Vimal Raj
- Narayana Hrudayalaya Hospital, Bangalore, Karnataka, India
| | - Yash Lokhandwala
- Mumbai & Visiting Faculty, Sion Hospital, Mumbai, Maharashtra, India
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22
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Pinn TL, Divers TJ, Southard T, De Bernardis NP, Wakshlag JJ, Valberg S. Persistent hypoglycemia associated with lipid storage myopathy in a paint foal. J Vet Intern Med 2018; 32:1442-1446. [PMID: 29957835 PMCID: PMC6060329 DOI: 10.1111/jvim.15218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/15/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022] Open
Abstract
A 12‐hours‐old Paint filly was examined because of weakness and dull mentation after birth. Despite IV administered dextrose, the foal remained persistently hypoglycemic with increase in serum activity of muscle and liver enzymes. A postmortem diagnosis of lipid myopathy most similar to multiple acyl‐CoA dehydrogenase deficiency (MADD) was confirmed by findings of myofiber lipid accumulation, elevated urine organic acids, and serum free acylcarnitines with respect to control foals. This report details a case of equine neonatal lipid storage myopathy with many biochemical characteristics of MADD. Lipid storage myopathies should be included as a differential diagnosis in foals with persistent weakness and hypoglycemia.
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Affiliation(s)
- Toby L Pinn
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Thomas J Divers
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Teresa Southard
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | | | - Joe J Wakshlag
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Stephanie Valberg
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan
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23
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Echaniz-Laguna A, Biancalana V, Gaignard P, Chanson JB. Primary carnitine deficiency in a 57-year-old patient with recurrent exertional rhabdomyolysis. BMJ Case Rep 2018; 2018:bcr-2018-224272. [PMID: 29895548 DOI: 10.1136/bcr-2018-224272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Rhabdomyolysis is an emergency requiring rapid diagnosis and suitable aetiological treatment. We describe the case of a 57-year-old man with recurrent exertional rhabdomyolysis who was diagnosed with systemic primary carnitine deficiency (SPCD). Clinical examination was normal, creatine kinase levels were elevated, plasma free carnitine concentration was mildly decreased, muscle biopsy demonstrated lipid accumulation, carnitine uptake in cultured fibroblasts was decreased and genetic analysis identified a homozygous pathologic c.1181_1183del in the SLC22A5 gene. Rhabdomyolysis did not recur after treatment with oral L-carnitine was introduced. SPCD is a rare autosomal recessive disorder of carnitine transportation usually manifesting as an infantile (hepatic) or a childhood myopathic (cardiac) condition and rarely affecting adults. Our case indicates that SPCD should be considered in the aetiological evaluation of adult patients with recurrent exertional rhabdomyolysis, even in the absence of myopathy and cardiomyopathy.
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Affiliation(s)
| | - Valérie Biancalana
- Laboratoire de Diagnostic Génétique, Hopitaux universitaires de Strasbourg, Strasbourg, France.,Physiopathologie des maladies neuromusculaires, Institut de Genetique et de Biologie Moleculaire et Cellulaire, Illkirch, France
| | - Pauline Gaignard
- Service de Biochimie, Hopital Bicetre, Le Kremlin-Bicetre, France
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Abstract
PURPOSE OF REVIEW This review aims to highlight the most relevant clinical and laboratory findings, regarding acute and progressive metabolic myopathies, and to develop an algorithm addressing clinicians to clinical practice. RECENT FINDINGS Although diagnosis of metabolic myopathies remains still challenging, the recent identification of new disorders has increased the number of patients requiring specific investigations. Nowadays, a more detailed characterization of the clinical spectrum of metabolic myopathies improved awareness as well as a deeper knowledge on their natural history or multisystem involvement. Diagnostic procedures, as first-line screening tests are necessary for an earlier and more accurate diagnostic work up, not only in infantile cases, but also in adults with suspected metabolic myopathies. New generation diagnostic techniques such as NGS (Next Generation Sequencing) and whole exome/genome sequencing have emerged as innovative tools to extensively evaluate either known genes variants or new candidate genes as possible causes of metabolic myopathies. SUMMARY Diagnosis of metabolic myopathies is still challenging for clinicians because of rarity and clinical heterogeneity which is often overlapping with other neuromuscular disorders. Detailed algorithms supported by advanced laboratory investigations may be helpful to timely reach a diagnosis, so allowing an earlier therapeutic decision.
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25
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Fontaine M, Kim I, Dessein AF, Mention-Mulliez K, Dobbelaere D, Douillard C, Sole G, Schiff M, Jaussaud R, Espil-Taris C, Boutron A, Wuyts W, Acquaviva C, Vianey-Saban C, Roland D, Joncquel-Chevalier Curt M, Vamecq J. Fluxomic assay-assisted diagnosis orientation in a cohort of 11 patients with myopathic form of CPT2 deficiency. Mol Genet Metab 2018; 123:441-448. [PMID: 29478820 DOI: 10.1016/j.ymgme.2018.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/09/2018] [Accepted: 02/10/2018] [Indexed: 12/31/2022]
Abstract
Carnitine palmitoyltransferase type 2 (CPT2) deficiency, a mitochondrial fatty acid oxidation disorder (MFAOD), is a cause of myopathy in its late clinical presentation. As for other MFAODs, its diagnosis may be evocated when blood acylcarnitine profile is abnormal. However, a lack of abnormalities or specificity in this profile is not exclusive of CPT2 deficiency. Our retrospective study reports clinical and biological data in a cohort of 11 patients with circulating acylcarnitine profile unconclusive enough for a specific diagnosis orientation. In these patients, CPT2 gene studies was prompted by prior fluxomic explorations of mitochondrial β-oxidation on intact whole blood cells incubated with pentadeuterated ([16-2H3, 15-2H2])-palmitate. Clinical indication for fluxomic explorations was at least one acute rhabdomyolysis episode complicated, in 5 of 11 patients, by acute renal failure. Major trigger of rhabdomyolysis was febrile infection. In all patients, fluxomic data indicated deficient CPT2 function showing normal deuterated palmitoylcarnitine (C16-Cn) formation rates associated with increased ratios between generated C16-Cn and downstream deuterated metabolites (Σ deuterated C2-Cn to C14-Cn). Subsequent gene studies showed in all patients pathogenic gene variants in either homozygous or compound heterozygous forms. Consistent with literature data, allelic frequency of the c.338C > T[p.Ser113Leu] mutation amounted to 68.2% in our cohort. Other missense mutations included c.149C > A[p.Pro50His] (9%), c.200C > G[p.Ala200Gly] (4.5%) and previously unreported c.1171A > G[p.ser391Gly] (4.5%) and c.1420G > C[p.Ala474Pro] (4.5%) mutations. Frameshift c.1666-1667delTT[p.Leu556val*16] mutation (9%) was observed in two patients unknown to be related.
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Affiliation(s)
- Monique Fontaine
- Department of Biochemistry and Molecular Biology, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center, CHRU Lille, 59037 Lille, France; Univ. Lille, RADEME - Maladies RAres du Développement et du Métabolisme: du phénotype au génotype et à la Fonction, Lille, EA 7364, France
| | - Isabelle Kim
- Department of Biochemistry and Molecular Biology, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center, CHRU Lille, 59037 Lille, France
| | - Anne-Frédérique Dessein
- Department of Biochemistry and Molecular Biology, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center, CHRU Lille, 59037 Lille, France
| | - Karine Mention-Mulliez
- Univ. Lille, RADEME - Maladies RAres du Développement et du Métabolisme: du phénotype au génotype et à la Fonction, Lille, EA 7364, France; Medical Reference Center for Inherited Metabolic Diseases, Jeanne de Flandre Hospital, CHRU, Lille, France
| | - Dries Dobbelaere
- Univ. Lille, RADEME - Maladies RAres du Développement et du Métabolisme: du phénotype au génotype et à la Fonction, Lille, EA 7364, France; Medical Reference Center for Inherited Metabolic Diseases, Jeanne de Flandre Hospital, CHRU, Lille, France
| | - Claire Douillard
- Medical Reference Center for Inherited Metabolic Diseases, Jeanne de Flandre Hospital, CHRU, Lille, France
| | - Guilhem Sole
- Centre de référence des Maladies Neuromusculaires AOC, Service de Neurologie, Hôpital Pellegrin CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Manuel Schiff
- Neurologie pédiatrique et maladies métaboliques, (C. Farnoux) - Pôle de pédiatrie médicale CHU, Hôpital Robert Debré, 48 boulevard Sérurier, 75019 Paris, France
| | - Roland Jaussaud
- Département de Médecine Interne et Immunologie Clinique Bâtiment Philippe Canton. Hôpitaux de Brabois Rue du Morvan, 54511 Vandoeuvre les Nancy Cedex, France
| | - Caroline Espil-Taris
- Neuropédiatrie Hôpital des enfants, Hôpital Pellegrin, Centre de référence des Maladies Neuromusculaires AOC, CHU de Bordeaux Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - Audrey Boutron
- Biochemistry Department, Hôpital de Bicêtre, Hôpitaux universitaires Paris-Sud, Assistance Publique - Hôpitaux de Paris, 94270 Le Kremlin Bicêtre, France
| | - Wim Wuyts
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Belgium
| | - Cécile Acquaviva
- Department of Inborn Errors of Metabolism and Neonatal Screening, Center of Biology and Pathology, CHU Lyon, Bron, France
| | - Christine Vianey-Saban
- Department of Inborn Errors of Metabolism and Neonatal Screening, Center of Biology and Pathology, CHU Lyon, Bron, France
| | - Dominique Roland
- Centre Agréé des Maladies Héréditaires du Métabolisme, Centre de Génétique Humaine, Institut de Pathologie et de Génétique, 25, Avenue Georges Lemaître, 6041 Charleroi, Gosselies, Belgium
| | - Marie Joncquel-Chevalier Curt
- Department of Biochemistry and Molecular Biology, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center, CHRU Lille, 59037 Lille, France; Univ. Lille, RADEME - Maladies RAres du Développement et du Métabolisme: du phénotype au génotype et à la Fonction, Lille, EA 7364, France
| | - Joseph Vamecq
- Department of Biochemistry and Molecular Biology, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center, CHRU Lille, 59037 Lille, France; Univ. Lille, RADEME - Maladies RAres du Développement et du Métabolisme: du phénotype au génotype et à la Fonction, Lille, EA 7364, France; Inserm, Lille, France.
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Phadke R. Myopathology of Adult and Paediatric Mitochondrial Diseases. J Clin Med 2017; 6:jcm6070064. [PMID: 28677615 PMCID: PMC5532572 DOI: 10.3390/jcm6070064] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 06/21/2017] [Accepted: 06/28/2017] [Indexed: 01/09/2023] Open
Abstract
Mitochondria are dynamic organelles ubiquitously present in nucleated eukaryotic cells, subserving multiple metabolic functions, including cellular ATP generation by oxidative phosphorylation (OXPHOS). The OXPHOS machinery comprises five transmembrane respiratory chain enzyme complexes (RC). Defective OXPHOS gives rise to mitochondrial diseases (mtD). The incredible phenotypic and genetic diversity of mtD can be attributed at least in part to the RC dual genetic control (nuclear DNA (nDNA) and mitochondrial DNA (mtDNA)) and the complex interaction between the two genomes. Despite the increasing use of next-generation-sequencing (NGS) and various omics platforms in unravelling novel mtD genes and pathomechanisms, current clinical practice for investigating mtD essentially involves a multipronged approach including clinical assessment, metabolic screening, imaging, pathological, biochemical and functional testing to guide molecular genetic analysis. This review addresses the broad muscle pathology landscape including genotype–phenotype correlations in adult and paediatric mtD, the role of immunodiagnostics in understanding some of the pathomechanisms underpinning the canonical features of mtD, and recent diagnostic advances in the field.
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Affiliation(s)
- Rahul Phadke
- Division of Neuropathology, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London WC1N 3BG, UK.
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK.
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McArdle disease: a "pediatric" disorder presenting in an adult with acute kidney injury. CEN Case Rep 2017; 6:156-160. [PMID: 28660497 DOI: 10.1007/s13730-017-0265-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022] Open
Abstract
Rhabdomyolysis is characterized by the acute breakdown of skeletal muscle, resulting in the release of muscle cell contents, subsequent myoglobinuria, and in severe cases, acute renal failure. A number of etiologies have been identified in acute rhabdomyolysis, in which drugs and trauma account for the majority of cases. One etiological category that is commonly overlooked in the adult population is an underlying genetic defect. This may be challenging to diagnose due to its rarity in the adult demographic and the marked heterogeneity, often requiring a high level of clinical suspicion before investigation is pursued. Once diagnosed, however, appropriate steps can be taken to reduce future episodes of rhabdomyolysis, further renal injury, and other systemic complications. Here, we report a case of an adult patient presenting with acute rhabdomyolysis secondary to McArdle disease, a genetic disease causing defective glycogenolysis. The case highlights the importance of recognizing the potential of undiagnosed "pediatric" disorders in adulthood and particularly for underlying genetic causes of rhabdomyolysis.
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Abstract
After the advances created by the use of cryostat sections and histochemistry 60 years ago, muscle histopathology is now living a real renaissance. In the field of genetic neuromuscular disorders, muscle biopsy analysis is fundamental to address questions about pathogenicity and protein expression when new genes are discovered through next-generation sequencing approaches. Moreover, the identification of the same gene mutated in previously considered distinct histopathologic entities imposes a constant reassessment of morphologic boundaries in several groups of disorders. In other fields like the acquired inflammatory myopathies, histologic analysis nowadays helps to affirm a diagnosis, set up therapeutic strategies, and verify the success of immunosuppressive treatment. In this exciting scenario morphologists are definitely key figures in the neuromuscular field. The objective of this chapter is to give an overview on morphology of the most frequent and recently identified muscle conditions, stressing the importance that only a combined analysis of clinical findings, muscle histology, and specific ancillary investigations is effective in reaching a precise diagnosis and orienting therapy.
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Affiliation(s)
- Edoardo Malfatti
- Neuromuscular Morphology Unit and Neuromuscular Pathology Reference Center Paris-Est, Center for Research in Myology, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.
| | - Norma Beatriz Romero
- Neuromuscular Morphology Unit and Neuromuscular Pathology Reference Center Paris-Est, Center for Research in Myology, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
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Tamarit J, Obis È, Ros J. Oxidative stress and altered lipid metabolism in Friedreich ataxia. Free Radic Biol Med 2016; 100:138-146. [PMID: 27296838 DOI: 10.1016/j.freeradbiomed.2016.06.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/07/2016] [Accepted: 06/10/2016] [Indexed: 12/31/2022]
Abstract
Friedreich ataxia is a genetic disease caused by the deficiency of frataxin, a mitochondrial protein. Frataxin deficiency impacts in the cell physiology at several levels. One of them is oxidative stress with consequences in terms of protein dysfunctions and metabolic alterations. Among others, alterations in lipid metabolism have been observed in several models of the disease. In this review we summarize the current knowledge of the molecular basis of the disease, the relevance of oxidative stress and the therapeutic strategies based on reduction of mitochondrial reactive oxygen species production. Finally, we will focus the interest in alterations of lipid metabolism as a consequence of mitochondrial dysfunction and describe the therapeutic approaches based on targeting lipid metabolism.
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Affiliation(s)
- Jordi Tamarit
- Departament de Ciències Mèdiques Bàsiques, IRB-Lleida, Universitat de Lleida, Lleida, Spain
| | - Èlia Obis
- Departament de Ciències Mèdiques Bàsiques, IRB-Lleida, Universitat de Lleida, Lleida, Spain
| | - Joaquim Ros
- Departament de Ciències Mèdiques Bàsiques, IRB-Lleida, Universitat de Lleida, Lleida, Spain.
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Bauquier J, Stent A, Gibney J, Jerrett I, White J, Tennent-Brown B, Pearce A, Pitt J. Evidence for marsh mallow (Malva parviflora
) toxicosis causing myocardial disease and myopathy in four horses. Equine Vet J 2016; 49:307-313. [DOI: 10.1111/evj.12604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022]
Affiliation(s)
- J. Bauquier
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - A. Stent
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - J. Gibney
- Victorian Department of Environment and Primary Industries; Bundoora Victoria Australia
| | - I. Jerrett
- Victorian Department of Environment and Primary Industries; Bundoora Victoria Australia
| | - J. White
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Parkville Victoria Australia
| | - B. Tennent-Brown
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - A. Pearce
- Golden Plains Equine; Bannockburn Victoria Australia
| | - J. Pitt
- Victorian Clinical Genetics Services; Royal Children's Hospital; Melbourne Victoria Australia
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Abstract
One large group of hereditary myopathies characterized by recurrent myoglobinuria, almost invariably triggered by exercise, comprises metabolic disorders of two main fuels, glycogen and long-chain fatty acids, or mitochondrial diseases of the respiratory chain. Differential diagnosis is required to distinguish the three conditions, although all cause a crisis of muscle energy. Muscle biopsy may be useful when performed well after the episode of rhabdomyolysis. Molecular genetics is increasingly the diagnostic test of choice to discover the underlying genetic basis.
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Béhin A, Acquaviva-Bourdain C, Souvannanorath S, Streichenberger N, Attarian S, Bassez G, Brivet M, Fouilhoux A, Labarre-Villa A, Laquerrière A, Pérard L, Kaminsky P, Pouget J, Rigal O, Vanhulle C, Eymard B, Vianey-Saban C, Laforêt P. Multiple acyl-CoA dehydrogenase deficiency (MADD) as a cause of late-onset treatable metabolic disease. Rev Neurol (Paris) 2016; 172:231-41. [PMID: 27038534 DOI: 10.1016/j.neurol.2015.11.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/11/2015] [Accepted: 11/15/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare, treatable, beta-oxidation disorder responsible for neuromuscular symptoms in adults. This case series describes the clinical and biochemical features of 13 French patients with late-onset MADD. METHODS AND RESULTS Thirteen ambulant patients (eight women, five men), with a median age at onset of 27 years, initially experienced exercise intolerance (n=9), isolated muscle weakness (n=1) and a multisystemic pattern with either central nervous system or hepatic dysfunction (n=3). During the worsening period, moderate rhabdomyolysis (n=5), a pseudomyasthenic pattern (n=5) and acute respiratory failure (n=1) have been observed. Weakness typically affected the proximal limbs and axial muscles, and there was sometimes facial asymmetry (n=3). Moderate respiratory insufficiency was noted in one case. Median baseline creatine kinase was 190IU/L. Lactacidemia was sometimes moderately increased at rest (3/10) and after exercise (1/3). The acylcarnitine profile was characteristic, with increases in all chain-length acylcarnitine species. Electromyography revealed a myogenic pattern, while muscle biopsy showed lipidosis, sometimes with COX-negative fibers (n=2). The mitochondrial respiratory chain was impaired in five cases, with coenzyme Q10 decreased in two cases. All patients harbored mutations in the ETFDH gene (four homozygous, seven compound heterozygous, two single heterozygous), with nine previously unidentified mutations. All patients were good responders to medical treatment, but exercise intolerance and/or muscular weakness persisted in 11 of them. CONCLUSION Late-onset forms of MADD may present as atypical beta-oxidation disorders. Acylcarnitine profiling and muscle biopsy remain the most decisive investigations for assessing the diagnosis. These tests should thus probably be performed more widely, particularly in unexplained cases of neuromuscular and multisystemic disorders.
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Affiliation(s)
- A Béhin
- AP-HP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
| | - C Acquaviva-Bourdain
- Centre de Référence des Maladies Héréditaires du Métabolisme, Inserm U820, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Bron, France
| | - S Souvannanorath
- AP-HP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - N Streichenberger
- Service de Neuropathologie, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Université Claude Bernard Lyon I, 69500 Bron, France
| | - S Attarian
- AP-HM, Centre de Référence des Maladies Neuromusculaires et de la SLA, CHU de La Timone, 13005 Marseille, France
| | - G Bassez
- AP-HP, Centre de Référence de Pathologie Neuromusculaire Paris-Ouest, CHU Henri-Mondor, Créteil, France
| | - M Brivet
- AP-HP, Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Robert-Debré, 75020 Paris, France
| | - A Fouilhoux
- Centre de Référence lyonnais des Maladies Héréditaires du Métabolisme, Groupement Hospitalier Est, Hôpital Femme Mère-Enfant, CHU de Lyon, 69500 Bron, France
| | - A Labarre-Villa
- Centre de Référence Rhône-Alpes des Maladies Neuromusculaires, CHU de Grenoble, 38000 Grenoble, France
| | - A Laquerrière
- Service d'Anatomie et Cytologie pathologiques, CHU de Rouen, 76000 Rouen, France
| | - L Pérard
- Service de Médecine Interne, Hôpital Édouard-Herriot, 69437 Lyon cedex 03, France
| | - P Kaminsky
- Centre de Référence des Maladies Neuromusculaires, CHU de Nancy (Hôpitaux de Brabois), 54500 Vandœuvre-Lès-Nancy, France
| | - J Pouget
- AP-HM, Centre de Référence des Maladies Neuromusculaires et de la SLA, CHU de La Timone, 13005 Marseille, France
| | - O Rigal
- AP-HP, Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Robert-Debré, 75020 Paris, France
| | - C Vanhulle
- Centre de Compétences Pathologies Neuromusculaires Enfants, Néonatalogie et Réanimation Pédiatrique, CHU de Rouen, 76000 Rouen, France
| | - B Eymard
- AP-HP, Centre de Référence de Pathologie Neuromusculaire Paris-Est, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - C Vianey-Saban
- Centre de Référence des Maladies Héréditaires du Métabolisme, Inserm U820, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, 69500 Bron, France
| | - P Laforêt
- AP-HP, Service de Biochimie, Hôpital de Bicêtre, 94270 Le Kremlin-Bicêtre, France
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Biegen VR, McCue JP, Donovan TA, Shelton GD. Metabolic Encephalopathy and Lipid Storage Myopathy Associated with a Presumptive Mitochondrial Fatty Acid Oxidation Defect in a Dog. Front Vet Sci 2015; 2:64. [PMID: 26664991 PMCID: PMC4672276 DOI: 10.3389/fvets.2015.00064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 11/12/2015] [Indexed: 12/31/2022] Open
Abstract
A 1-year-old spayed female Shih Tzu presented for episodic abnormalities of posture and mentation. Neurological examination was consistent with a bilaterally symmetric multifocal encephalopathy. The dog had a waxing-and-waning hyperlactemia and hypoglycemia. Magnetic resonance imaging revealed bilaterally symmetric cavitated lesions of the caudate nuclei with less severe abnormalities in the cerebellar nuclei. Empirical therapy was unsuccessful, and the patient was euthanized. Post-mortem histopathology revealed bilaterally symmetric necrotic lesions of the caudate and cerebellar nuclei and multi-organ lipid accumulation, including a lipid storage myopathy. Malonic aciduria and ketonuria were found on urinary organic acid screen. Plasma acylcarnitine analysis suggested a fatty acid oxidation defect. Fatty acid oxidation disorders are inborn errors of metabolism documented in humans, but poorly described in dogs. Although neurological signs have been described in humans with this group of diseases, descriptions of advanced imaging, and histopathology are severely lacking. This report suggests that abnormalities of fatty acid metabolism may cause severe, bilateral gray matter necrosis, and lipid accumulation in multiple organs including the skeletal muscles, liver, and kidneys. Veterinarians should be aware that fatty acid oxidation disorders, although potentially fatal, may be treatable. A timely definitive diagnosis is essential in guiding therapy.
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Affiliation(s)
| | | | | | - G Diane Shelton
- The Department of Pathology, School of Medicine, University of California San Diego , La Jolla, CA , USA
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Houten SM, Violante S, Ventura FV, Wanders RJA. The Biochemistry and Physiology of Mitochondrial Fatty Acid β-Oxidation and Its Genetic Disorders. Annu Rev Physiol 2015; 78:23-44. [PMID: 26474213 DOI: 10.1146/annurev-physiol-021115-105045] [Citation(s) in RCA: 465] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mitochondrial fatty acid β-oxidation (FAO) is the major pathway for the degradation of fatty acids and is essential for maintaining energy homeostasis in the human body. Fatty acids are a crucial energy source in the postabsorptive and fasted states when glucose supply is limiting. But even when glucose is abundantly available, FAO is a main energy source for the heart, skeletal muscle, and kidney. A series of enzymes, transporters, and other facilitating proteins are involved in FAO. Recessively inherited defects are known for most of the genes encoding these proteins. The clinical presentation of these disorders may include hypoketotic hypoglycemia, (cardio)myopathy, arrhythmia, and rhabdomyolysis and illustrates the importance of FAO during fasting and in hepatic and (cardio)muscular function. In this review, we present the current state of knowledge on the biochemistry and physiological functions of FAO and discuss the pathophysiological processes associated with FAO disorders.
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Affiliation(s)
- Sander M Houten
- Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029; ,
| | - Sara Violante
- Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029; ,
| | - Fatima V Ventura
- Metabolism and Genetics Group, Research Institute for Medicines and Pharmaceutical Sciences, iMed.ULisboa, 1649-003 Lisboa, Portugal; .,Department of Biochemistry and Human Biology, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal
| | - Ronald J A Wanders
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, University of Amsterdam, 1100 DE Amsterdam, The Netherlands; .,Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Chan EK, Kornberg AJ, Ryan MM. A diagnostic approach to recurrent myalgia and rhabdomyolysis in children. Arch Dis Child 2015; 100:793-7. [PMID: 25633066 DOI: 10.1136/archdischild-2014-307663] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 01/08/2015] [Indexed: 11/03/2022]
Abstract
Episodic myalgia is a common complaint in children and young adults. While many cases remain idiopathic even after extensive investigation, myalgia can be the first symptom of an underlying serious neuromuscular condition, and can be associated with an increased risk of such serious complications as rhabdomyolysis and malignant hyperthermia. We review and highlight the metabolic myopathies and other increasingly recognised muscle disorders that may present to paediatricians with episodic myalgia or isolated episodes of rhabdomyolysis, and propose a diagnostic algorithm for investigation of these complaints.
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Affiliation(s)
- Eunice K Chan
- Children's Neurosciences Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Andrew J Kornberg
- Children's Neurosciences Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Monique M Ryan
- Children's Neurosciences Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Hamel Y, Mamoune A, Mauvais FX, Habarou F, Lallement L, Romero NB, Ottolenghi C, de Lonlay P. Acute rhabdomyolysis and inflammation. J Inherit Metab Dis 2015; 38:621-8. [PMID: 25778939 DOI: 10.1007/s10545-015-9827-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 02/07/2023]
Abstract
Rhabdomyolysis results from the rapid breakdown of skeletal muscle fibers, which leads to leakage of potentially toxic cellular content into the systemic circulation. Acquired causes by direct injury to the sarcolemma are most frequent. The inherited causes are: i) metabolic with failure of energy production, including mitochondrial fatty acid ß-oxidation defects, LPIN1 mutations, inborn errors of glycogenolysis and glycolysis, more rarely mitochondrial respiratory chain deficiency, purine defects and peroxysomal α-methyl-acyl-CoA-racemase defect (AMACR), ii) structural causes with muscle dystrophies and myopathies, iii) calcium pump disorder with RYR1 gene mutations, iv) inflammatory causes with myositis. Irrespective of the cause of rhabdomyolysis, the pathology follows a common pathway, either by the direct injury to sarcolemma by increased intracellular calcium concentration (acquired causes) or by the failure of energy production (inherited causes), which leads to fiber necrosis. Rhabdomyolysis are frequently precipitated by febrile illness or exercise. These conditions are associated with two events, elevated temperature and high circulating levels of pro-inflammatory mediators such as cytokines and chemokines. To illustrate these points in the context of energy metabolism, protein thermolability and the potential benefits of arginine therapy, we focus on a rare cause of rhabdomyolysis, aldolase A deficiency. In addition, our studies on lipin-1 (LPIN1) deficiency raise the possibility that several diseases involved in rhabdomyolysis implicate pro-inflammatory cytokines and may even represent primarily pro-inflammatory diseases. Thus, not only thermolability of mutant proteins critical for muscle function, but also pro-inflammatory cytokines per se, may lead to metabolic decompensation and rhabdomyolysis.
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Affiliation(s)
- Yamina Hamel
- Institut Imagine, Institut National de la Santé et de la Recherche Médicale, Unité 1163, 75015, Paris, France
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Abstract
Metabolic and mitochondrial myopathies encompass a heterogeneous group of disorders that result in impaired energy production in skeletal muscle. Symptoms of premature muscle fatigue, sometimes leading to myalgia, rhabdomyolysis, and myoglobinuria, typically occur with exercise that would normally depend on the defective metabolic pathway. But in another group of these disorders, the dominant muscle symptom is weakness. This article reviews the clinical features, diagnosis, and management of these diseases with emphasis on the recent literature.
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Affiliation(s)
- Lydia J Sharp
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Neuromuscular Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, 7232 Greenville Avenue, Dallas, TX 75231, USA
| | - Ronald G Haller
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Neuromuscular Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, 7232 Greenville Avenue, Dallas, TX 75231, USA; North Texas VA Medical Center, 4500 South Lancaster Road, Dallas, TX 75216, USA.
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Whitaker CH, Felice KJ, Silvers D, Wu Q. Fulminant lipid storage myopathy due to multiple acyl-coenzyme a dehydrogenase deficiency. Muscle Nerve 2015; 52:289-93. [DOI: 10.1002/mus.24552] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Charles H. Whitaker
- Department of Neuromuscular Medicine; Hospital for Special Care; 2150 Corbin Avenue New Britain Connecticut 06053 USA
| | - Kevin J. Felice
- Department of Neuromuscular Medicine; Hospital for Special Care; 2150 Corbin Avenue New Britain Connecticut 06053 USA
| | - David Silvers
- Department of Neurology; Hartford Hospital; Hartford Connecticut USA
| | - Qian Wu
- Deparment of Pathology; University of Connecticut Health Center; Farmington Connecticut USA
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Wu JW, Yang H, Wang SP, Soni KG, Brunel-Guitton C, Mitchell GA. Inborn errors of cytoplasmic triglyceride metabolism. J Inherit Metab Dis 2015; 38:85-98. [PMID: 25300978 DOI: 10.1007/s10545-014-9767-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 08/25/2014] [Indexed: 01/14/2023]
Abstract
Triglyceride (TG) synthesis, storage, and degradation together constitute cytoplasmic TG metabolism (CTGM). CTGM is mostly studied in adipocytes, where starting from glycerol-3-phosphate and fatty acyl (FA)-coenzyme A (CoA), TGs are synthesized then stored in cytoplasmic lipid droplets. TG hydrolysis proceeds sequentially, producing FAs and glycerol. Several reactions of CTGM can be catalyzed by more than one enzyme, creating great potential for complex tissue-specific physiology. In adipose tissue, CTGM provides FA as a systemic energy source during fasting and is related to obesity. Inborn errors and mouse models have demonstrated the importance of CTGM for non-adipose tissues, including skeletal muscle, myocardium and liver, because steatosis and dysfunction can occur. We discuss known inborn errors of CTGM, including deficiencies of: AGPAT2 (a form of generalized lipodystrophy), LPIN1 (childhood rhabdomyolysis), LPIN2 (an inflammatory condition, Majeed syndrome, described elsewhere in this issue), DGAT1 (protein loosing enteropathy), perilipin 1 (partial lipodystrophy), CGI-58 (gene ABHD5, neutral lipid storage disease (NLSD) with ichthyosis and "Jordan's anomaly" of vacuolated polymorphonuclear leukocytes), adipose triglyceride lipase (ATGL, gene PNPLA2, NLSD with myopathy, cardiomyopathy and Jordan's anomaly), hormone-sensitive lipase (HSL, gene LIPE, hypertriglyceridemia, and insulin resistance). Two inborn errors of glycerol metabolism are known: glycerol kinase (GK, causing pseudohypertriglyceridemia) and glycerol-3-phosphate dehydrogenase (GPD1, childhood hepatic steatosis). Mouse models often resemble human phenotypes but may diverge markedly. Inborn errors have been described for less than one-third of CTGM enzymes, and new phenotypes may yet be identified.
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Affiliation(s)
- Jiang Wei Wu
- Division of Medical Genetics, Department of Pediatrics, Université de Montréal and CHU Sainte-Justine, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
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Mamoune A, Bahuau M, Hamel Y, Serre V, Pelosi M, Habarou F, Nguyen Morel MA, Boisson B, Vergnaud S, Viou MT, Nonnenmacher L, Piraud M, Nusbaum P, Vamecq J, Romero N, Ottolenghi C, Casanova JL, de Lonlay P. A thermolabile aldolase A mutant causes fever-induced recurrent rhabdomyolysis without hemolytic anemia. PLoS Genet 2014; 10:e1004711. [PMID: 25392908 PMCID: PMC4230727 DOI: 10.1371/journal.pgen.1004711] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 08/26/2014] [Indexed: 01/19/2023] Open
Abstract
Aldolase A deficiency has been reported as a rare cause of hemolytic anemia occasionally associated with myopathy. We identified a deleterious homozygous mutation in the ALDOA gene in 3 siblings with episodic rhabdomyolysis without hemolytic anemia. Myoglobinuria was always triggered by febrile illnesses. We show that the underlying mechanism involves an exacerbation of aldolase A deficiency at high temperatures that affected myoblasts but not erythrocytes. The aldolase A deficiency was rescued by arginine supplementation in vitro but not by glycerol, betaine or benzylhydantoin, three other known chaperones, suggesting that arginine-mediated rescue operated by a mechanism other than protein chaperoning. Lipid droplets accumulated in patient myoblasts relative to control and this was increased by cytokines, and reduced by dexamethasone. Our results expand the clinical spectrum of aldolase A deficiency to isolated temperature-dependent rhabdomyolysis, and suggest that thermolability may be tissue specific. We also propose a treatment for this severe disease.
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Affiliation(s)
- Asmaa Mamoune
- INSERM U781, Institut Imagine des Maladies Génétiques, Université Paris Descartes et Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker, AP-HP, Paris, France
| | - Michel Bahuau
- Département de Génétique, Hôpitaux Universitaires Henri-Mondor, Créteil, AP-HP, France
| | - Yamina Hamel
- INSERM U781, Institut Imagine des Maladies Génétiques, Université Paris Descartes et Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker, AP-HP, Paris, France
| | - Valérie Serre
- "Mitochondria, Metals and Oxidative Stress" group, Jacques Monod Institute, UMR7592 CNRS, Paris Diderot University, Paris, France
| | - Michele Pelosi
- INSERM U781, Institut Imagine des Maladies Génétiques, Université Paris Descartes et Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker, AP-HP, Paris, France
| | - Florence Habarou
- Metabolic biochemistry and INSERM U1124, University Paris Descartes, Hospital Necker Enfants Malades, Paris, France
| | | | - Bertrand Boisson
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, United States of America; Unité Institut National de la Santé et de la Recherche Médicale U980, Laboratory of Human Genetics of Infectious Diseases, Imagine Institute; and Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, University Paris Descartes, Paris, France
| | - Sabrina Vergnaud
- Département de Biochimie, Toxicologie et Pharmacologie, CHU de Grenoble, Centre de Référence Rhône-Alpes des Maladies NeuroMusculaires, Grenoble, France
| | - Mai Thao Viou
- Université Pierre et Marie Curie, UM 76, INSERM U974, CNRS UMR 7215, Institut de Myologie, GHU Pitié-Salpêtrière, AP-HP, Centre de Référence des Maladies Neuromusculaires, Paris, France
| | - Luc Nonnenmacher
- Université Pierre et Marie Curie, UM 76, INSERM U974, CNRS UMR 7215, Institut de Myologie, GHU Pitié-Salpêtrière, AP-HP, Centre de Référence des Maladies Neuromusculaires, Paris, France
| | - Monique Piraud
- Laboratoire Maladies Héréditaires du Métabolisme, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | | | - Joseph Vamecq
- INSERM et Laboratoire de Biochimie et Biologie Moléculaire, HMNO, CBP, CHRU Lille, Lille, France
| | - Norma Romero
- Département de Biochimie, Toxicologie et Pharmacologie, CHU de Grenoble, Centre de Référence Rhône-Alpes des Maladies NeuroMusculaires, Grenoble, France
| | - Chris Ottolenghi
- Université Pierre et Marie Curie, UM 76, INSERM U974, CNRS UMR 7215, Institut de Myologie, GHU Pitié-Salpêtrière, AP-HP, Centre de Référence des Maladies Neuromusculaires, Paris, France
| | - Jean-Laurent Casanova
- Clinique Universitaire de Pédiatrie, Hôpital couple enfant, CHU de Grenoble, France
- Howard Hughes Medical Institute, New York, New York, United States of America
| | - Pascale de Lonlay
- INSERM U781, Institut Imagine des Maladies Génétiques, Université Paris Descartes et Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker, AP-HP, Paris, France
- * E-mail:
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Suzuki A, Nagasaka H, Ochi Y, Kobayashi K, Nakamura H, Nakatani D, Yamaguchi S, Yamaki S, Wada A, Shirata Y, Hui SP, Toda T, Kuroda H, Chiba H, Hirano KI. Peripheral leukocyte anomaly detected with routine automated hematology analyzer sensitive to adipose triglyceride lipase deficiency manifesting neutral lipid storage disease with myopathy/triglyceride deposit cardiomyovasculopathy. Mol Genet Metab Rep 2014; 1:249-253. [PMID: 27896096 PMCID: PMC5121313 DOI: 10.1016/j.ymgmr.2014.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 05/05/2014] [Accepted: 05/05/2014] [Indexed: 01/10/2023] Open
Abstract
Adipose triglyceride lipase (ATGL) deficiency manifesting neutral lipid storage disease with myopathy/triglyceride deposit cardiomyovasculopathy presents distinct fat-containing vacuoles known as Jordans' anomaly in peripheral leucocytes. To develop an automatic notification system for Jordans' anomaly in ATGL-deficient patients, we analyzed circulatory leukocyte scattergrams on automated hematology analyzer XE-5000. The BASO-WX and BASO-WY values were found to be significantly higher in patients than those in non-affected subjects. The two parameters measured by automated hematology analyzer may be expected to provide an important diagnostic clue for homozygous ATGL deficiency.
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Affiliation(s)
- Akira Suzuki
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics (CNT), Graduate School of Medicine, Osaka University, Suita, Osaka 565-0874, Japan
| | - Hironori Nagasaka
- Department of Pediatrics, Takarazuka City Hospital, Takarazuka 665-0827, Japan
| | - Yasuhiro Ochi
- Scientific Affairs, Sysmex Corporation, Kobe 651-2241, Japan
| | - Kazuhiro Kobayashi
- Division of Neurology/Molecular Brain Science, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hiroshi Nakamura
- Department of Community Health and Medicine, Yamaguchi University, School of Medicine, Ube 755-8505, Japan
| | - Daisaku Nakatani
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics (CNT), Graduate School of Medicine, Osaka University, Suita, Osaka 565-0874, Japan
| | - Satoshi Yamaguchi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics (CNT), Graduate School of Medicine, Osaka University, Suita, Osaka 565-0874, Japan
| | - Shinobu Yamaki
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan
| | - Atsushi Wada
- Scientific Affairs, Sysmex Corporation, Kobe 651-2241, Japan
| | | | - Shu-Ping Hui
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan
| | - Tatsushi Toda
- Division of Neurology/Molecular Brain Science, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hiroshi Kuroda
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Hitoshi Chiba
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan
| | - Ken-Ichi Hirano
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics (CNT), Graduate School of Medicine, Osaka University, Suita, Osaka 565-0874, Japan
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Elf K, Shevchenko G, Nygren I, Larsson L, Bergquist J, Askmark H, Artemenko K. Alterations in muscle proteome of patients diagnosed with amyotrophic lateral sclerosis. J Proteomics 2014; 108:55-64. [PMID: 24846852 DOI: 10.1016/j.jprot.2014.05.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/24/2014] [Accepted: 05/11/2014] [Indexed: 12/13/2022]
Abstract
UNLABELLED Amyotrophic lateral sclerosis (ALS) is a motor neuron disease characterized by progressive muscle paralysis. Currently clinical tools for ALS diagnostics do not perform well enough and their improvement is needed. The objective of this study was to identify specific protein alterations related to the development of ALS using tiny muscle biopsies. We applied a shotgun proteomics and quantitative dimethyl labeling in order to analyze the global changes in human skeletal muscle proteome of ALS versus healthy subjects for the first time. 235 proteins were quantified and 11 proteins were found significantly regulated in ALS muscles. These proteins are involved in muscle development and contraction, metabolic processes, enzyme activity, regulation of apoptosis and transport activity. In order to eliminate a risk to confuse ALS with other denervations, muscle biopsies of patients with postpolio syndrome and Charcot-Marie-Tooth disease (negative controls) were compared to those of ALS and controls. Only few proteins significantly regulated in ALS patients compared to controls were affected differently in negative controls. These proteins (BTB and kelch domain-containing protein 10, myosin light chain 3, glycogen debranching enzyme, transitional endoplasmic reticulum ATPase), individually or as a panel, could be selected for estimation of ALS diagnosis and development. BIOLOGICAL SIGNIFICANCE ALS is a devastating neurodegenerative disease, and luckily, very rare: only one to two people out of 100,000 develop ALS yearly. This fact, however, makes studies of ALS very challenging since it is very difficult to collect the representative set of clinical samples and this may take up to several years. In this study we collected the muscle biopsies from 12 ALS patients and compared the ALS muscle proteome against the one from control subjects. We suggested the efficient method for such comprehensive quantitative analysis by LC-MS and performed it for the first time using human ALS material. This gel- and antibody-free method can be widely applied for muscle proteome studies and has been used by us for revealing of the specific protein alterations associated with ALS.
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Affiliation(s)
- Kristin Elf
- Department of Neuroscience, Unit of Neurophysiology, Uppsala University, Uppsala, Sweden
| | - Ganna Shevchenko
- Department of Chemistry-BMC, Analytical Chemistry, Uppsala University, Uppsala, Sweden
| | - Ingela Nygren
- Department of Neuroscience, Unit of Neurology, Uppsala University, Uppsala, Sweden
| | - Lars Larsson
- Department of Neuroscience, Unit of Neurophysiology, Uppsala University, Uppsala, Sweden
| | - Jonas Bergquist
- Department of Chemistry-BMC, Analytical Chemistry, Uppsala University, Uppsala, Sweden
| | - Håkan Askmark
- Department of Neuroscience, Unit of Neurology, Uppsala University, Uppsala, Sweden
| | - Konstantin Artemenko
- Department of Chemistry-BMC, Analytical Chemistry, Uppsala University, Uppsala, Sweden.
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Diekman EF, van der Pol WL, Nievelstein RAJ, Houten SM, Wijburg FA, Visser G. Muscle MRI in patients with long-chain fatty acid oxidation disorders. J Inherit Metab Dis 2014; 37:405-13. [PMID: 24305961 DOI: 10.1007/s10545-013-9666-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/12/2013] [Accepted: 11/20/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Muscle magnetic resonance imaging (MRI) is a useful tool for visualizing abnormalities in neuromuscular disorders. The value of muscle MRI has not been studied in long-chain fatty acid oxidation (lcFAO) disorders. LcFAO disorders may present with metabolic myopathy including episodic rhabdomyolysis. OBJECTIVE To investigate whether lcFAO disorders are associated with muscle MRI abnormalities. METHODS Lower body MRI was performed in 20 patients with lcFAO disorders, i.e. three carnitine palmitoyltransferase 2 deficiency (CPT2D), 12 very long-chain acyl-CoA dehydrogenase deficiency (VLCADD), three mitochondrial trifunctional protein deficiency (MTPD) and two isolated long-chain hydroxyacyl-CoA dehydrogenase deficiency (LCHADD). RESULTS At the time of MRI, four patients had muscle weakness, 14 had muscle pain and 13 were exercise intolerant. Median creatine kinase (CK) level of patients at the day of MRI was 398 U/L (range 35-12,483). T1W and STIR signal intensity (SI) were markedly increased in MTPD patients from girdle to lower leg. VLCADD patients showed predominantly proximal T1W SI changes, whereas LCHADD patients mostly showed distal T1W SI changes. Prominent STIR weighted signal intensity increases of almost all muscle groups were observed in patients with VLCADD and LCHADD with very high CK (>11.000) levels. CONCLUSIONS AND RELEVANCE lcFAO disorders are associated with specific patterns of increased T1W and STIR signal intensity. These patterns may reflect lipid accumulation and inflammation secondary to lcFAO defects and progressive muscle damage. Future studies are needed to investigate whether muscle MRI might be a useful tool to monitor disease course and to study pathogenesis of lcFAO related myopathy.
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Affiliation(s)
- Eugene F Diekman
- Department of Paediatric Gastroenterology and Metabolic Diseases, Wilhelmina Children's Hospital, UMC Utrecht, KC 03.063.0, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
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Perrin L, Féasson L, Furby A, Laforêt P, Petit FM, Gautheron V, Chabrier S. PNPLA2 mutation: A paediatric case with early onset but indolent course. Neuromuscul Disord 2013; 23:986-91. [DOI: 10.1016/j.nmd.2013.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 07/30/2013] [Accepted: 08/19/2013] [Indexed: 12/16/2022]
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Liewluck T, Mundi MS, Mauermann ML. Mitochondrial trifunctional protein deficiency: a rare cause of adult-onset rhabdomyolysis. Muscle Nerve 2013; 48:989-91. [PMID: 23868323 DOI: 10.1002/mus.23959] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Mitochondrial trifunctional protein deficiency is a rare autosomal recessive disorder of mitochondrial fatty acid β-oxidation that may be due to mutations in 2 different nuclear genes, HADHA and HADHB. Perturbation of this multienzyme complex compromises the oxidation of long-chain fatty acids, which leads to multiorgan dysfunction. Childhood- or adolescent-onset recurrent rhabdomyolysis is a common muscular manifestation and is preceded frequently by clinically overt peripheral neuropathy. METHODS In this report we describe a patient with late adult-onset recurrent rhabdomyolysis. RESULTS Despite normal sensory examination, nerve conduction studies showed a mild axonal peripheral neuropathy. The acylcarnitine profile showed elevated long-chain and 3-hydroxy long-chain acylcarnitine species. HADHA sequencing revealed known compound heterozygous mutations c.180+3A>G (p.Thr37SerfsX6) and c.1528G>C (p.Glu510Gln). During a 10-month follow-up period, he had no further episodes of rhabdomyolysis after appropriate dietary modifications. CONCLUSIONS Mitochondrial trifunctional protein deficiency should be considered in patients with adult-onset recurrent rhabdomyolysis, especially in those with either clinically overt or subclinical peripheral neuropathy.
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Affiliation(s)
- Teerin Liewluck
- Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota, 55905, USA
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47
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Sullivan K, El-Hoss J, Quinlan KGR, Deo N, Garton F, Seto JTC, Gdalevitch M, Turner N, Cooney GJ, Kolanczyk M, North KN, Little DG, Schindeler A. NF1 is a critical regulator of muscle development and metabolism. Hum Mol Genet 2013; 23:1250-9. [PMID: 24163128 DOI: 10.1093/hmg/ddt515] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is emerging evidence for reduced muscle function in children with neurofibromatosis type 1 (NF1). We have examined three murine models featuring NF1 deficiency in muscle to study the effect on muscle function as well as any underlying pathophysiology. The Nf1(+/-) mouse exhibited no differences in overall weight, lean tissue mass, fiber size, muscle weakness as measured by grip strength or muscle atrophy-recovery with limb disuse, although this model lacks many other characteristic features of the human disease. Next, muscle-specific knockout mice (Nf1muscle(-/-)) were generated and they exhibited a failure to thrive leading to neonatal lethality. Intramyocellular lipid accumulations were observed by electron microscopy and Oil Red O staining. More mature muscle specimens lacking Nf1 expression taken from the limb-specific Nf1Prx1(-/-) conditional knockout line showed a 10-fold increase in muscle triglyceride content. Enzyme assays revealed a significant increase in the activities of oxidative metabolism enzymes in the Nf1Prx1(-/-) mice. Western analyses showed increases in the expression of fatty acid synthase and the hormone leptin, as well as decreased expression of a number of fatty acid transporters in this mouse line. These data support the hypothesis that NF1 is essential for normal muscle function and survival and are the first to suggest a direct link between NF1 and mitochondrial fatty acid metabolism.
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48
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Recent advances in clinical neurogenetics. J Neurol 2013; 260:2451-7. [DOI: 10.1007/s00415-012-6757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 11/06/2012] [Accepted: 11/09/2012] [Indexed: 11/24/2022]
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49
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Perevoshchikova IV, Quinlan CL, Orr AL, Gerencser AA, Brand MD. Sites of superoxide and hydrogen peroxide production during fatty acid oxidation in rat skeletal muscle mitochondria. Free Radic Biol Med 2013; 61:298-309. [PMID: 23583329 PMCID: PMC3871980 DOI: 10.1016/j.freeradbiomed.2013.04.006] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 02/01/2013] [Accepted: 04/05/2013] [Indexed: 12/22/2022]
Abstract
H2O2 production by skeletal muscle mitochondria oxidizing palmitoylcarnitine was examined under two conditions: the absence of respiratory chain inhibitors and the presence of myxothiazol to inhibit complex III. Without inhibitors, respiration and H2O2 production were low unless carnitine or malate was added to limit acetyl-CoA accumulation. With palmitoylcarnitine alone, H2O2 production was dominated by complex II (44% from site IIF in the forward reaction); the remainder was mostly from complex I (34%, superoxide from site IF). With added carnitine, H2O2 production was about equally shared between complexes I, II, and III. With added malate, it was 75% from complex III (superoxide from site IIIQo) and 25% from site IF. Thus complex II (site IIF in the forward reaction) is a major source of H2O2 production during oxidation of palmitoylcarnitine ± carnitine. Under the second condition (myxothiazol present to keep ubiquinone reduced), the rates of H2O2 production were highest in the presence of palmitoylcarnitine ± carnitine and were dominated by complex II (site IIF in the reverse reaction). About half the rest was from site IF, but a significant portion, ∼40pmol H2O2·min(-1)·mg protein(-1), was not from complex I, II, or III and was attributed to the proteins of β-oxidation (electron-transferring flavoprotein (ETF) and ETF-ubiquinone oxidoreductase). The maximum rate from the ETF system was ∼200pmol H2O2·min(-1)·mg protein(-1) under conditions of compromised antioxidant defense and reduced ubiquinone pool. Thus complex II and the ETF system both contribute to H2O2 productionduring fatty acid oxidation under appropriate conditions.
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Affiliation(s)
| | | | - Adam L Orr
- Buck Institute for Research on Aging, Novato, CA 94945, USA
| | | | - Martin D Brand
- Buck Institute for Research on Aging, Novato, CA 94945, USA
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50
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Ramakrishnan S, Narayanappa G, Christopher R. Lipid storage myopathy with clinical markers of Marfan syndrome: A rare association. Ann Indian Acad Neurol 2013; 15:332-5. [PMID: 23349609 PMCID: PMC3548382 DOI: 10.4103/0972-2327.104352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 12/30/2011] [Accepted: 02/25/2012] [Indexed: 12/30/2022] Open
Abstract
Disorders of lipid metabolism can cause variable clinical presentations, often involving skeletal muscle, alone or together with other tissues. A 19-year-old boy presented with a 2-year history of muscle pain, cramps, exercise intolerance and progressive weakness of proximal lower limbs. Examination revealed skeletal markers of Marfan syndrome in the form of increased arm span compared with height, Kyphoscoliois, moderate pectus excavatum, high arched palate and wrist sign. He also had mild neck flexor weakness and proximal lower limb weakness with areflexia. Pathologic findings revealed lipid-laden fine vacuoles in the muscle fibers. Possibility of carnitine deficiency myopathy was considered and the patient was started on carnitine and Co Q. The patient made remarkable clinical improvement over the next 2 months. This case is reported for rarity of the association of clinical markers of Marfan syndrome and lipid storage myopathy and sparse literature on lipid storage myopathy in the Indian context.
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Affiliation(s)
- Subasree Ramakrishnan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
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