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Tong F, Zhang Y, Chen C, Zhu L, Lu Y, Zhang Z, Chen T, Yan J, Zheng J, Zhao X, Zhou D, Yang X, Yang R, Cang X, Jiang P, Shu Q. Long-term prognosis of 35 patients with methionine adenosyltransferase deficiency based on newborn screening in China. Front Cell Dev Biol 2023; 10:1059680. [PMID: 36704196 PMCID: PMC9871361 DOI: 10.3389/fcell.2022.1059680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Methionine adenosyltransferase deficiency (MATD) is a rare metabolic disorder caused by mono- or biallelic MAT1A mutations that are not yet well understood. Of the 4,065,644 neonates screened between November 2010 and December 2021, 35 individuals have been diagnosed with an estimated incidence of 1: 116,161 by a cutoff value of methionine 82.7 μmol/L and follow-up over 11 years. MATD patients with autosomal recessive (AR) type had higher clinical and genetic heterogeneity than those with autosomal dominant (AD) type. Fifteen unrelated AD patients harbored one well-known dominant variant, c.791 G>A or c.776 C>T, and were clinically unaffected with a mean plasma methionine (Met) value <300 μmol/L. Twenty AR cases have unique genotypes and presented a wide range of clinical abnormalities from asymptomatic to white matter lesions. Of them, 10 AR patients displayed severe manifestations, such as verbal difficulty, motor delay, development delay, and white matter lesions, with mean Met >500 μmol/L and thereby were treated with a methionine-restricted diet alone or in combination with betaine, folate, or vitamin B6, and were healthy finally. Neurological abnormalities were evidenced in two patients (P16 and P27) with Met values >800 μmol/L by MRI scan. Neurological abnormalities were reversed here by liver transplantation or by the determination of S-adenosylmethionine supplementation. Additionally, 38 variants of MAT1A were distributed within patients and carriers, of which 24 were novel and mostly predicted to be damaged. Our findings with an extensive clinical and genetic dataset provided new insights into its diagnosis and treatment and will be helpful for its optimal management in the future.
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Affiliation(s)
- Fan Tong
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuchen Zhang
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China,Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China
| | - Chi Chen
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Ling Zhu
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yijun Lu
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China,Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhanming Zhang
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Chen
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaxuan Yan
- Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Zheng
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoxu Zhao
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Duo Zhou
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Yang
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Rulai Yang
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaohui Cang
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China,Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China
| | - Pingping Jiang
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China,Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Qiang Shu, ; Pingping Jiang,
| | - Qiang Shu
- Department of Genetics and Metabolism, The Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada,*Correspondence: Qiang Shu, ; Pingping Jiang,
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Zhao D, Ni M, Jia C, Li X, Zhu X, Liu S, Su L, Lv S, Wang L, Jia L. Genomic analysis of 9 infants with hypermethioninemia by whole-exome sequencing among in Henan, China. Clin Chim Acta 2022; 533:109-113. [PMID: 35760084 DOI: 10.1016/j.cca.2022.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/23/2022] [Accepted: 06/18/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hypermethioninemia is an inborn error of metabolism with elevated plasma methionine (Met) caused by methionine adenosyltransferase deficiency. Methionine adenosyltransferase (MAT) I/III deficiency is the most common cause of hypermethioninemia. Except for increased blood Met, most patients have no symptoms, but a small number have nervous system complications, including cognitive impairment and mental retardation. OBJECTIVE To investigate the gene variation of patients with hypermethioninemia in newborns in Henan province. METHODS 9 cases of hypermethioninemia were screened for amino acids profile and acyl carnitine by tandem mass spectrometric (MS/MS) among 245 054 newborns. We performed whole-exome sequencing on 9 families of infants with hypermethioninemia. We identified mutated genes under different models of inheritance and further assessed these mutations through Sanger sequencing and association analysis. RESULTS The incidence of neonatal hypermethioninemia was 1:27 228 in Henan province. A total of ten mutations in the MAT1A gene in the 9 patients were identified, including nine reported mutations (c.1070C>T, c.895C>T, c.100T>A, c.315C>A, c.529C>T, c.623A>C, c.407G>T, c.1066C>T, 867G>T) and one novel mutations (c.772G>C). c.772G>C was detected in 2 families and is the most common variant. 7 infants (7/9) with hypermethioninemia were genetically autosomal dominant, and 2 infants (2/9) with hypermethioninemia were genetically autosomal recessive. CONCLUSION Our findings expand the mutational spectrum of hypermethioninemia, with the description of one new mutation. They improve the understanding of the genetic background and clinical manifestation of MAT1A in Chinese patients.
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Affiliation(s)
- Dehua Zhao
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Min Ni
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Chenlu Jia
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Xiaole Li
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Xinyun Zhu
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Suna Liu
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China.
| | - Li Su
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Shubo Lv
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Liwen Wang
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China
| | - Liting Jia
- Department of Henan Newborn Screening Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450054, China.
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A High-Methionine Diet for One-Week Induces a High Accumulation of Methionine in the Cerebrospinal Fluid and Confers Bipolar Disorder-like Behavior in Mice. Int J Mol Sci 2022; 23:ijms23020928. [PMID: 35055113 PMCID: PMC8778486 DOI: 10.3390/ijms23020928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
Methionine (Met) is considered the most toxic amino acid in mammals. Here, we investigated biochemical and behavioral impacts of ad libitum one-week feeding of high-Met diets on mice. Adult male mice were fed the standard rodent diet that contained 0.44% Met (1×) or a diet containing 16 graded Met doses (1.2×–13×). High-Met diets for one-week induced a dose-dependent decrease in body weight and an increase in serum Met levels with a 2.55 mM peak (versus basal 53 µM) on the 12×Met diet. Total homocysteine (Hcy) levels were also upregulated while concentrations of other amino acids were almost maintained in serum. Similarly, levels of Met and Hcy (but not the other amino acids) were highly elevated in the cerebrospinal fluids of mice on the 10×Met diet; the Met levels were much higher than Hcy and the others. In a series of behavioral tests, mice on the 10×Met diet displayed increased anxiety and decreased traveled distances in an open-field test, increased activity to escape from water soaking and tail hanging, and normal learning/memory activity in a Y-maze test, which were reflections of negative/positive symptoms and normal cognitive function, respectively. These results indicate that high-Met ad libitum feeding even for a week can induce bipolar disorder-like disease models in mice.
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Bannick A, Chase S, Miner A, Seeterlin M, Conway RL. Methionine adenosyltransferase I/III deficiency: Long-term follow-up and treatment of 3 adult siblings. Eur J Med Genet 2020; 63:104076. [PMID: 32980525 DOI: 10.1016/j.ejmg.2020.104076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/14/2020] [Accepted: 09/20/2020] [Indexed: 11/17/2022]
Abstract
Methionine adenosyltransferase I/III deficiency, also known as Mudd's disease, is a rare inborn error of methionine metabolism. Because pathophysiological mechanisms of the disease remain poorly understood, the consequences of this disorder and the need for medical management remain uncertain; likewise, the effect of medical interventions on clinical outcomes in Mudd's disease is largely unknown due to a relative lack of published longitudinal clinical data. There are few reports of adults in the medical literature affected with this disease. Clinical symptoms of reported adults range from asymptomatic to individuals with neurological, developmental, or behavioral symptoms. Here we report three siblings affected with Mudd's disease that were ascertained following an abnormal newborn screen for hypermethioninemia in the case of our index patient. All three had a variable degree of longstanding neurologic or psychiatric symptoms which had not prompted a clinical investigation for a genetic or metabolic disorder prior to identification through our clinic. While the causal association of these symptoms to the metabolic disorder remains unclear in these cases, all three patients demonstrated a degree of amelioration of symptoms and/or improvement in measurements on standardized psychiatric ratings scales when specific therapy for the metabolic disorder was instituted. The symptoms, treatment, and outcomes over the course of six years of follow-up are presented here, expanding the possible natural history of Mudd's disease.
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Affiliation(s)
- Allison Bannick
- Division of Genetic, Genomic and Metabolic Disorders, Children's Hospital of Michigan, Detroit, MI, United States.
| | - Sara Chase
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Alyson Miner
- Division of Genetic, Genomic and Metabolic Disorders, Children's Hospital of Michigan, Detroit, MI, United States
| | - Mary Seeterlin
- Michigan Department of Health and Human Services, Lansing, MI, United States
| | - Robert L Conway
- Division of Genetic, Genomic and Metabolic Disorders, Children's Hospital of Michigan, Detroit, MI, United States; Wayne State University School of Medicine, Detroit, MI, United States
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5
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Zhang Z, Wang Y, Ma D, Cheng W, Sun Y, Jiang T. Analysis of five cases of hypermethioninemia diagnosed by neonatal screening. J Pediatr Endocrinol Metab 2020; 33:47-52. [PMID: 31851615 DOI: 10.1515/jpem-2019-0285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/14/2019] [Indexed: 11/15/2022]
Abstract
Background Hypermethioninemia is a group of diseases with elevated plasma methionine (Met) caused by hereditary and non-hereditary factors, although it could also be caused by administration of the amino acid Met. Among these, the disease caused by methionine adenosyltransferase (MAT) I/III deficiency is the most common, and is characterized by persistent, isolated hypermethioninemia as well as slightly elevated homocysteine. S-adenosylmethionine is the product of Met, which can be used as a direct methyl donor of many substances, such as choline and nucleotide, and essential in the development of the body. Among the patients, most have no symptoms, and a small number have central nervous system complications with high levels of plasma Met, including mental retardation, cognitive impairment and special breathing odor. Methods In this study, five cases of MAT I/III deficiency were diagnosed and retrospectively analyzed among 220,000 newborns. Patients with high Met levels received a Met-restricted diet treatment. Results and conclusions MAT I/III deficiency is a common reason for Met elevation in neonatal screening by tandem mass spectrometry (MS/MS), which needs long-term follow-up except for these patients with explicitly benign mutations.
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Affiliation(s)
- Zhilei Zhang
- Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yanyun Wang
- Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Dingyuan Ma
- Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Wei Cheng
- Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yun Sun
- Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Tao Jiang
- Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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6
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Nashabat M, Al-Khenaizan S, Alfadhel M. Methionine adenosyltransferase I/III deficiency: beyond the central nervous system manifestations. Ther Clin Risk Manag 2018; 14:225-229. [PMID: 29440907 PMCID: PMC5798556 DOI: 10.2147/tcrm.s151732] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Methionine adenosyltransferase (MAT) I/III deficiency (OMIM # 250850) is caused by a mutation in MAT1A, which encodes the two hepatic MAT isozymes I and III. With the implementation of newborn screening program to discover hypermethioninemia due to cystathionine beta-synthase deficiency, more cases are being discovered. While the majority of patients are asymptomatic, some might have central nervous system (CNS) and extra-CNS manifestations. Although neurologic manifestations and demyelination have been correlated to MAT deficiency in many reported cases, none of the previous reports focused on extra-CNS manifestations associated with the disease. This is a retrospective chart review for a 40-month-old patient with confirmed diagnosis of MAT deficiency. He was found to have a novel homozygous disease-causing variant in MAT1A (NM_000429.2) c.1081G>T (p.Val361Phe). Interestingly, our patient had an unexplained zinc and iron deficiency in addition to mild speech delay. We reviewed the literature and summarized all the reported extra-CNS manifestations. In conclusion, MAT deficiency patients should be thoroughly investigated to check for CNS and extra-CNS manifestations associated with the disease. Keeping in consideration the challenge of assuming correlation, a scrutinized look at extra-CNS manifestations and their course with time might pave the way to understanding the pathophysiology of the disease and MAT1A function.
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Affiliation(s)
- Marwan Nashabat
- King Abdullah International Medical Research Centre, King Saud bin Abdulaziz University for Health Sciences, Division of Genetics, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Sultan Al-Khenaizan
- Department of Dermatology, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Majid Alfadhel
- King Abdullah International Medical Research Centre, King Saud bin Abdulaziz University for Health Sciences, Division of Genetics, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
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7
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Stabler SP, Freehauf C, Allen RH, Thomas J, Gallagher R. Potential Misdiagnosis of Hyperhomocysteinemia due to Cystathionine Beta-Synthase Deficiency During Pregnancy. JIMD Rep 2017; 37:55-61. [PMID: 28275971 DOI: 10.1007/8904_2017_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/08/2017] [Accepted: 02/13/2017] [Indexed: 12/23/2022] Open
Abstract
Extreme hyperhomocysteinemia with low cystathionine and cysteine is virtually diagnostic of cystathionine beta-synthase (CBS) deficiency since remethylation defects and hypermethioninemia due to other inborn errors cause elevated serum cystathionine. However, a pregnant CBS deficient patient was found to have elevated cystathionine in addition to elevated total homocysteine and methionine at 23 weeks of gestation and post-delivery cystathionine decreased to the lower level of normal. A second patient with cystathionine values during gestation also showed a rise from the low pre-pregnant value to massive elevation by delivery. Her infant had severe hyperhomocysteinemia in cord blood with a massive elevation of cystathionine, S-adenosylmethionine, and S-adenosylhomocysteine. The infant corrected her homocysteine value by 2 months and is not affected. This data demonstrates that the fetus when exposed to high homocysteine and methionine has increased synthesis of cystathionine which cannot be cleared because the fetus lacks cystathionine gamma-lyase, and thus cystathionine is returned to the mother's circulation. This situation could lead to a misdiagnosis of the cause of hyperhomocysteinemia in a previously undiagnosed pregnant CBS deficient patient. Assays combining homocysteine with cystathionine measurements are commonly available from commercial laboratories in the USA. The recognition of CBS deficiency vs. remethylation disorders is important in order to maximize treatment. The cord blood values revealed a major disturbance in methionine metabolism including a potential for impaired transmethylation reactions in the fetus due to the buildup of S-adenosylhomocysteine. It is possible that monitoring maternal cystathionine during gestation could provide another measure of fetal exposure to homocysteine.
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Affiliation(s)
- Sally P Stabler
- Division of Hematology, Department of Medicine, University of Colorado School of Medicine, 12700 E. 19th Avenue, Room 9122, Bldg. RC2, Campus Box B170, Aurora, CO, USA.
| | - Cynthia Freehauf
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert H Allen
- Division of Hematology, Department of Medicine, University of Colorado School of Medicine, 12700 E. 19th Avenue, Room 9122, Bldg. RC2, Campus Box B170, Aurora, CO, USA
| | - Janet Thomas
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Renata Gallagher
- Department of Pediatrics, University of California at San Francisco, 330 Post Street, 6th Floor, San Francisco, CA, USA
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8
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Chien YH, Abdenur JE, Baronio F, Bannick AA, Corrales F, Couce M, Donner MG, Ficicioglu C, Freehauf C, Frithiof D, Gotway G, Hirabayashi K, Hofstede F, Hoganson G, Hwu WL, James P, Kim S, Korman SH, Lachmann R, Levy H, Lindner M, Lykopoulou L, Mayatepek E, Muntau A, Okano Y, Raymond K, Rubio-Gozalbo E, Scholl-Bürgi S, Schulze A, Singh R, Stabler S, Stuy M, Thomas J, Wagner C, Wilson WG, Wortmann S, Yamamoto S, Pao M, Blom HJ. Mudd's disease (MAT I/III deficiency): a survey of data for MAT1A homozygotes and compound heterozygotes. Orphanet J Rare Dis 2015; 10:99. [PMID: 26289392 PMCID: PMC4545930 DOI: 10.1186/s13023-015-0321-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 08/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper summarizes the results of a group effort to bring together the worldwide available data on patients who are either homozygotes or compound heterozygotes for mutations in MAT1A. MAT1A encodes the subunit that forms two methionine adenosyltransferase isoenzymes, tetrameric MAT I and dimeric MAT III, that catalyze the conversion of methionine and ATP to S-adenosylmethionine (AdoMet). Subnormal MAT I/III activity leads to hypermethioninemia. Individuals, with hypermethioninemia due to one of the MAT1A mutations that in heterozygotes cause relatively mild and clinically benign hypermethioninemia are currently often being flagged in screening programs measuring methionine elevation to identify newborns with defective cystathionine β-synthase activity. Homozygotes or compound heterozygotes for MAT1A mutations are less frequent. Some but not all, such individuals have manifested demyelination or other CNS abnormalities. PURPOSE OF THE STUDY The goals of the present effort have been to determine the frequency of such abnormalities, to find how best to predict whether they will occur, and to evaluate the outcomes of the variety of treatment regimens that have been used. Data have been gathered for 64 patients, of whom 32 have some evidence of CNS abnormalities (based mainly on MRI findings), and 32 do not have such evidence. RESULTS AND DISCUSSION The results show that mean plasma methionine concentrations provide the best indication of the group into which a given patient will fall: those with means of 800 μM or higher usually have evidence of CNS abnormalities, whereas those with lower means usually do not. Data are reported for individual patients for MAT1A genotypes, plasma methionine, total homocysteine (tHcy), and AdoMet concentrations, liver function studies, results of 15 pregnancies, and the outcomes of dietary methionine restriction and/or AdoMet supplementation. Possible pathophysiological mechanisms that might contribute to CNS damage are discussed, and tentative suggestions are put forth as to optimal management.
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Affiliation(s)
- Yin-Hsiu Chien
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Children's Hospital Building, Taipei, Taiwan
| | - Jose E Abdenur
- Division of Metabolic Disorders, CHOC Children's, Orange, CA, USA
| | - Federico Baronio
- Newborn Screening and Inborn Errors of Metabolism Regional Centre, Pediatric Endocrinology Program, Pediatric Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Allison Anne Bannick
- Children's Hospital of Michigan Metabolic Clinic, Detroit Medical Center, Detroit, MI, USA
| | - Fernando Corrales
- Department of Hepatology, Proteomics laboratory, Center for Applied Medical Research (CIMA), University of Navarra, IdiSNA, Pamplona, Spain
| | - Maria Couce
- Head of Metabolic Unit, Department Pediatrics, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - Markus G Donner
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Can Ficicioglu
- The Children's Hospital of Philadelphia, Division of Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Cynthia Freehauf
- Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - Deborah Frithiof
- Department of Clinical Sciences, Pediatrics Umeå University, SE 901 85, Umeå, Sweden
| | - Garrett Gotway
- Department of Pediatrics, Division of Genetics and Metabolism; Department of Internal Medicine, Division of Clinical Genetics; and McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Koichi Hirabayashi
- Department of Pediatrics, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Japan
| | - Floris Hofstede
- Division of Paediatrics, Department of Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - George Hoganson
- Department of Pediatrics, University of Illinois at Chicago, College of Medicine, Chicago, Il, USA
| | - Wuh-Liang Hwu
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Children's Hospital Building, Taipei, Taiwan
| | - Philip James
- Children's Hospital Boston, Harvard Medical School, Boston, USA
| | - Sook Kim
- KSZ Children's Hospital/Korea Genetics Research Center, Jikjidaero, Heung Duck Gu, Cheng Ju City, Chung Buk, Republic of Korea
| | - Stanley H Korman
- Department of Genetics and Department of Metabolic Diseases, Hebrew University, Hadassah Medical Center, Jerusalem, Israel
| | - Robin Lachmann
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Harvey Levy
- Children's Hospital Boston, Harvard Medical School, Boston, USA
| | - Martin Lindner
- Department of General Pediatrics, Division of Pediatric Metabolic Medicine and Neuropediatrics, University Hospital Heidelberg, Heidelberg, Germany
- Department of Neurology, University Children's Hospital Frankfurt, Frankfurt, Germany
| | - Lilia Lykopoulou
- First Department of Pediatrics, University of Athens, Agia Sofia Children's Hospital, Athens, Greece
| | - Ertan Mayatepek
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Duesseldorf, Duesseldorf, Germany
| | - Ania Muntau
- University Children's Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Yoshiyuki Okano
- Department of Genetics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Japan
| | - Kimiyo Raymond
- Department of Medicine and Pathology, Biochemical Genetics Laboratory, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Estela Rubio-Gozalbo
- Department of Pediatrics and Laboratory Genetic Metabolic Diseases, Maastricht University Medical Center, Maastricht, Netherlands
| | - Sabine Scholl-Bürgi
- Medical University of Innsbruck, Clinic for Pediatrics, Inherited Metabolic Disorders, Innsbruck, Austria
| | - Andreas Schulze
- Genetics and Genome Biology, Peter Gilgan Center for Research and Learning The Hospital for Sick Children, Toronto, ON, Canada
| | - Rani Singh
- Department of Human Genetics and Pediatric, Emory University, Atlanta, GA, USA
| | - Sally Stabler
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mary Stuy
- Department of Medical and Molecular Genetics Indiana University School of Medicine, Indianapolis, IN, USA
| | - Janet Thomas
- Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - Conrad Wagner
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, Tn, USA
| | - William G Wilson
- Division of Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Saskia Wortmann
- Nijmegen Centre for Mitochondrial Disorders (NCMD), RadboudUMC, Amalia Children's Hospital, Nijmegen, The Netherlands
| | | | - Maryland Pao
- Laboratory of Molecular Biology, National Institute of Mental Health, Bethesda, MD, USA
| | - Henk J Blom
- Laboratory for Clinical Biochemistry and Metabolism, Center for Pediatrics and Adolescent Medicine University Hospital Freiburg, 79106, Freiburg, Germany.
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Multi-tissue computational modeling analyzes pathophysiology of type 2 diabetes in MKR mice. PLoS One 2014; 9:e102319. [PMID: 25029527 PMCID: PMC4100879 DOI: 10.1371/journal.pone.0102319] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 06/18/2014] [Indexed: 12/25/2022] Open
Abstract
Computational models using metabolic reconstructions for in silico simulation of metabolic disorders such as type 2 diabetes mellitus (T2DM) can provide a better understanding of disease pathophysiology and avoid high experimentation costs. There is a limited amount of computational work, using metabolic reconstructions, performed in this field for the better understanding of T2DM. In this study, a new algorithm for generating tissue-specific metabolic models is presented, along with the resulting multi-confidence level (MCL) multi-tissue model. The effect of T2DM on liver, muscle, and fat in MKR mice was first studied by microarray analysis and subsequently the changes in gene expression of frank T2DM MKR mice versus healthy mice were applied to the multi-tissue model to test the effect. Using the first multi-tissue genome-scale model of all metabolic pathways in T2DM, we found out that branched-chain amino acids' degradation and fatty acids oxidation pathway is downregulated in T2DM MKR mice. Microarray data showed low expression of genes in MKR mice versus healthy mice in the degradation of branched-chain amino acids and fatty-acid oxidation pathways. In addition, the flux balance analysis using the MCL multi-tissue model showed that the degradation pathways of branched-chain amino acid and fatty acid oxidation were significantly downregulated in MKR mice versus healthy mice. Validation of the model was performed using data derived from the literature regarding T2DM. Microarray data was used in conjunction with the model to predict fluxes of various other metabolic pathways in the T2DM mouse model and alterations in a number of pathways were detected. The Type 2 Diabetes MCL multi-tissue model may explain the high level of branched-chain amino acids and free fatty acids in plasma of Type 2 Diabetic subjects from a metabolic fluxes perspective.
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Toue S, Kodama R, Amao M, Kawamata Y, Kimura T, Sakai R. Screening of toxicity biomarkers for methionine excess in rats. J Nutr 2006; 136:1716S-1721S. [PMID: 16702345 DOI: 10.1093/jn/136.6.1716s] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although many animal studies have reported that dietary excess of methionine causes toxic changes including growth suppression and hemolytic anemia, the biochemical mechanism and biomarkers for methionine toxicity have not been well elucidated. The present study aimed to identify toxicity biomarkers from plasma metabolites in rats fed excessive methionine. Young growing rats were fed graded doses of additional methionine for 2 wk. Cluster analysis of multivariate correlations was performed on the physiological and toxicity variables with plasma metabolites detected by GC/MS, amino acid analyzer, and thiol-specific analysis. Indicative variables for hemolysis such as splenic nonheme iron content and plasma bilirubin were grouped in the same cluster as many methionine metabolites. Homocysteine and some undefined metabolites in this cluster were found to be strong discriminators between nontoxic and toxic levels of methionine intake. Product-to-precursor ratios of each methionine metabolite demonstrated that excessive methionine intake caused a marked decrease only in the ratio of cystathionine to homocysteine, suggesting that metabolism from homocysteine to cystathionine would be rate limiting in the disposal of excessive methionine. Collectively from these results, homocysteine appeared to be the most plausible biomarker to assess methionine excess as a surrogate marker both for toxicity and for setting a metabolic upper limit.
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Affiliation(s)
- Sakino Toue
- Ajinomoto Co., Inc., Institute of Life Sciences, Kawasaki, Japan
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Abstract
Increasing numbers of individuals with inherited metabolic disorders are surviving into adulthood and considering their reproductive options. This paper discusses a practical approach to supporting such individuals, focusing on issues concerning fertility, the impact of pregnancy on metabolism and the metabolic disorder itself on the pregnancy, as well as highlighting the need to pay special attention during the postpartum period. Apart from pregnancies in women with phenylketonuria, there is a dearth of data in this area and a great need for collection of information within registries to aid our understanding of potential problems and counselling of women and their partners.
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Affiliation(s)
- Philip J Lee
- The Charles Dent Metabolic Unit, The National Hospital for Neurology and Neurosurgery, Post Box 92, Queen Square, London, WC1N 3BG, UK.
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Sakai R, Miura M, Amao M, Kodama R, Toue S, Noguchi Y, Kimura T. Potential approaches to the assessment of amino acid adequacy in rats: a progress report. J Nutr 2004; 134:1651S-1655S; discussion 1664S-1666S, 1667S-1672S. [PMID: 15173446 DOI: 10.1093/jn/134.6.1651s] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We report on research progress on two approaches that may be useful in determining the upper adequacy range for macronutrients such as amino acids. One approach was to attempt to identify "toxic metabolites" that were responsible for toxicity or biomarkers for the toxicity of excessive intake of an amino acid in rats. We found that there was hepatic toxicity that was specifically associated with L-cystine excess, but not with L-cysteine excess. We analyzed urine samples from rats fed basal diets or L-cystine or L-cysteine excess diets and identified 25 peaks from gas chromatography mass spectrometry analysis that were specific for L-cystine excess and also correlated with toxicity markers. Another approach was to try to identify "metabolic limits" by measuring CO(2) arising from amino acid excess. Uniformly (13)C labeled L-leucine was used as tracer, in diets with added L-leucine fed to rats, and (13)CO(2) arising from its metabolism was collected over 24 h and the fraction of the ingested L-leucine that was exhaled as CO(2) was calculated. The fractional exhalation of (13)CO(2) increased with increasing L-leucine dose, but showed an inflexion point at approximately 8.9 g/kg body weight, after which it reached a plateau. This suggested that >8.9 g/kg BW, the catabolism of L-leucine changed and this approximately coincided with the dose above which a statistically significant decrease in body weight was seen.
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Affiliation(s)
- Ryosei Sakai
- Institute of Life Sciences and Research Institute for Health Fundamentals, Ajinomoto Co., Inc., Kawasaki, Japan
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