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Zhang K, Pan X, Zheng J, Liu Y, Sun L. The metabolic analysis in human aortic tissues of aortic dissection. J Clin Lab Anal 2022; 36:e24623. [PMID: 35881684 PMCID: PMC9459286 DOI: 10.1002/jcla.24623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background The metabolic profile of human aortic tissues is of great importance. Among the analytical platforms utilized in metabolomics, LC‐MS provides broad metabolome coverage. The non‐targeted metabolomics can comprehensively detect the entire metabolome of an organism and find the metabolic characteristics that have significant changes in the experimental group and the control group and elucidate the metabolic pathway concerning the recognized metabolites. Employing non‐targeted metabolomics is helpful to develop biomarkers for disease diagnosis and disease pathology research; for instance, Aortic aneurysm (AA) and Aortic dissection (AD). Aim This study sought to describe the non‐targeted analysis of 18 aortic tissue samples, comparing between AA and AD. Material & Methods Our experimental flow included dividing the samples into (AA, nine samples) and (AD, nine samples), SCIEX quadrupole timeofflight tandem mass spectrometer (TripleTOF) 6600+ mass spectrometer data refinement, MetDNA database analysis, and pathway analysis. We performed an initial validation by setting quality control parameters to evaluate the stability of the analysis system during the computer operation. We then used the repeatability of the control samples to examine the stability of the instrument during the entire analysis process to ensure the reliability of the results. Results Our study found 138 novel metabolites involved in galactose metabolism. Discussion 138 novel metabolites found in this study will be further studied in the future. Conclusion Our study found 138 novel metabolites between AA and AD, which will provide viable clinical data for future studies aimed to implement galactose markers in aortic tissue analysis.
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Affiliation(s)
- Kefeng Zhang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Aortic Disease Center, Beijing, China
| | - Xudong Pan
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Aortic Disease Center, Beijing, China
| | - Jun Zheng
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Aortic Disease Center, Beijing, China
| | - Yongmin Liu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Aortic Disease Center, Beijing, China
| | - Lizhong Sun
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Aortic Disease Center, Beijing, China
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Leuger L, Dieu X, Chao de la Barca JM, Moriconi M, Halley G, Donin de Rosière X, Reynier P, Mirebeau‐Prunier D, Homedan C. Late-onset argininosuccinic aciduria in a 72-year-old man presenting with fatal hyperammonemia. JIMD Rep 2021; 62:44-48. [PMID: 34765397 PMCID: PMC8574183 DOI: 10.1002/jmd2.12251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 11/07/2022] Open
Abstract
Argininosuccinate lyase deficiency (ASLD, MIM #207900) is an inherited urea cycle disorder. There are mainly two clinical forms, an acute neonatal form which manifests as life-threatening hyperammonemia, and a late-onset form characterised by polymorphic neuro-cognitive or psychiatric presentation with transient hyperammonemia episodes. Here, we report a late-onset case of ASLD in a 72-year-old man carrying a homozygous pathogenic variant in the exon 16 of the ASL gene, presenting for the first time with fatal hyperammonemic coma. This case report shows the need to systematically carry out an ammonia assay when faced with an unexplained coma.
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Affiliation(s)
- Laurent Leuger
- Laboratoire de Biochimie et biologie moléculaire, Centre Hospitalier Universitaire d'AngersAngers Cedex 9France
| | - Xavier Dieu
- Laboratoire de Biochimie et biologie moléculaire, Centre Hospitalier Universitaire d'AngersAngers Cedex 9France
| | | | - Mikael Moriconi
- Service de Réanimation Polyvalente et Unité de soins continus, Centre Hospitalier de CornouailleQuimper CedexFrance
| | - Guillaume Halley
- Service de Réanimation Polyvalente et Unité de soins continus, Centre Hospitalier de CornouailleQuimper CedexFrance
| | | | - Pascal Reynier
- Laboratoire de Biochimie et biologie moléculaire, Centre Hospitalier Universitaire d'AngersAngers Cedex 9France
| | - Delphine Mirebeau‐Prunier
- Laboratoire de Biochimie et biologie moléculaire, Centre Hospitalier Universitaire d'AngersAngers Cedex 9France
| | - Chadi Homedan
- Laboratoire de Biochimie et biologie moléculaire, Centre Hospitalier Universitaire d'AngersAngers Cedex 9France
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3
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Guan T, Xin Y, Zheng K, Wang R, Zhang X, Jia S, Li S, Cao C, Zhao X. Metabolomics analysis of the effects of quercetin on renal toxicity induced by cadmium exposure in rats. Biometals 2020; 34:33-48. [PMID: 33033991 DOI: 10.1007/s10534-020-00260-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/01/2020] [Indexed: 02/08/2023]
Abstract
This study aims to explore the protective effects of quercetin against cadmium-induced nephrotoxicity utilizing metabolomics methods. Male Sprague-Dawley rats were randomly assigned to six groups: control, different dosages of quercetin (10 and 50 mg/kg·bw, respectively), CdCl2 (4.89 mg/kg·bw) and different dosages quercetin plus CdCl2 groups. After 12 weeks, the kidneys were collected for metabolomics analysis and histopathology examination. In total, 11 metabolites were confirmed, the intensities of which significantly changed (up-regulated or down-regulated) compared with the control group (p < 0.00067). These metabolites include xanthosine, uric acid (UA), guanidinosuccinic acid (GSA), hypoxanthine (Hyp), 12-hydroxyeicosatetraenoic acid (tetranor 12-HETE), taurocholic acid (TCA), hydroxyphenylacetylglycine (HPAG), deoxyinosine (DI), ATP, formiminoglutamic acid (FIGLU) and arachidonic acid (AA). When high-dose quercetin and cadmium were given to rats concurrently, the intensities of above metabolites significantly restored (p < 0.0033 or p < 0.00067). The results showed quercetin attenuated Cd-induced nephrotoxicity by regulating the metabolism of lipids, amino acids, and purine, inhibiting oxidative stress, and protecting kidney functions.
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Affiliation(s)
- Tong Guan
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Youwei Xin
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Kai Zheng
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Ruijuan Wang
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Xia Zhang
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Siqi Jia
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Siqi Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China
| | - Can Cao
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China.
| | - Xiujuan Zhao
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, 194 Xuefu Road, Harbin, 150081, Heilongjiang, China.
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4
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Baruteau J, Jameson E, Morris AA, Chakrapani A, Santra S, Vijay S, Kocadag H, Beesley CE, Grunewald S, Murphy E, Cleary M, Mundy H, Abulhoul L, Broomfield A, Lachmann R, Rahman Y, Robinson PH, MacPherson L, Foster K, Chong WK, Ridout DA, Bounford KM, Waddington SN, Mills PB, Gissen P, Davison JE. Expanding the phenotype in argininosuccinic aciduria: need for new therapies. J Inherit Metab Dis 2017; 40:357-368. [PMID: 28251416 PMCID: PMC5393288 DOI: 10.1007/s10545-017-0022-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This UK-wide study defines the natural history of argininosuccinic aciduria and compares long-term neurological outcomes in patients presenting clinically or treated prospectively from birth with ammonia-lowering drugs. METHODS Retrospective analysis of medical records prior to March 2013, then prospective analysis until December 2015. Blinded review of brain MRIs. ASL genotyping. RESULTS Fifty-six patients were defined as early-onset (n = 23) if symptomatic < 28 days of age, late-onset (n = 23) if symptomatic later, or selectively screened perinatally due to a familial proband (n = 10). The median follow-up was 12.4 years (range 0-53). Long-term outcomes in all groups showed a similar neurological phenotype including developmental delay (48/52), epilepsy (24/52), ataxia (9/52), myopathy-like symptoms (6/52) and abnormal neuroimaging (12/21). Neuroimaging findings included parenchymal infarcts (4/21), focal white matter hyperintensity (4/21), cortical or cerebral atrophy (4/21), nodular heterotopia (2/21) and reduced creatine levels in white matter (4/4). 4/21 adult patients went to mainstream school without the need of additional educational support and 1/21 lives independently. Early-onset patients had more severe involvement of visceral organs including liver, kidney and gut. All early-onset and half of late-onset patients presented with hyperammonaemia. Screened patients had normal ammonia at birth and received treatment preventing severe hyperammonaemia. ASL was sequenced (n = 19) and 20 mutations were found. Plasma argininosuccinate was higher in early-onset compared to late-onset patients. CONCLUSIONS Our study further defines the natural history of argininosuccinic aciduria and genotype-phenotype correlations. The neurological phenotype does not correlate with the severity of hyperammonaemia and plasma argininosuccinic acid levels. The disturbance in nitric oxide synthesis may be a contributor to the neurological disease. Clinical trials providing nitric oxide to the brain merit consideration.
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Affiliation(s)
- Julien Baruteau
- Gene Transfer Technology Group, Institute for Women’s Health, University College London, London, UK
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
- Genetics and Genomic Medicine Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Elisabeth Jameson
- Metabolic Medicine Department, Royal Manchester Children Hospital NHS Foundation Trust, Manchester, UK
| | - Andrew A. Morris
- Metabolic Medicine Department, Royal Manchester Children Hospital NHS Foundation Trust, Manchester, UK
| | - Anupam Chakrapani
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
- Metabolic Medicine Department, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - Saikat Santra
- Metabolic Medicine Department, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - Suresh Vijay
- Metabolic Medicine Department, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - Huriye Kocadag
- Gene Transfer Technology Group, Institute for Women’s Health, University College London, London, UK
| | - Clare E. Beesley
- North East Thames Regional Genetic Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Stephanie Grunewald
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
| | - Elaine Murphy
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Maureen Cleary
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
| | - Helen Mundy
- Metabolic Medicine Department, Evelina Children’s Hospital, London, UK
| | - Lara Abulhoul
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
| | - Alexander Broomfield
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
- Metabolic Medicine Department, Royal Manchester Children Hospital NHS Foundation Trust, Manchester, UK
| | - Robin Lachmann
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Yusof Rahman
- Metabolic Medicine Department, St Thomas Hospital, London, UK
| | - Peter H. Robinson
- Paediatric Metabolic Medicine, Royal Hospital for Sick Children, Glasgow, UK
| | - Lesley MacPherson
- Neuroradiology Department, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - Katharine Foster
- Neuroradiology Department, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - W. Kling Chong
- Neuroradiology Department, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Deborah A. Ridout
- Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
| | | | - Simon N. Waddington
- Gene Transfer Technology Group, Institute for Women’s Health, University College London, London, UK
- Wits/SAMRC Antiviral Gene Therapy Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philippa B. Mills
- Genetics and Genomic Medicine Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Paul Gissen
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
- Genetics and Genomic Medicine Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
| | - James E. Davison
- Metabolic Medicine Department, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH London, UK
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Novel biomarkers of abdominal aortic aneurysm disease: identifying gaps and dispelling misperceptions. BIOMED RESEARCH INTERNATIONAL 2014; 2014:925840. [PMID: 24967416 PMCID: PMC4055358 DOI: 10.1155/2014/925840] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/29/2014] [Accepted: 05/04/2014] [Indexed: 11/17/2022]
Abstract
Abdominal aortic aneurysm (AAA) is a prevalent and potentially life-threatening disease. Early detection by screening programs and subsequent surveillance has been shown to be effective at reducing the risk of mortality due to aneurysm rupture. The aim of this review is to summarize the developments in the literature concerning the latest biomarkers (from 2008 to date) and their potential screening and therapeutic values. Our search included human studies in English and found numerous novel biomarkers under research, which were categorized in 6 groups. Most of these studies are either experimental or hampered by their low numbers of patients. We concluded that currently no specific laboratory markers allow screeing for the disease and monitoring its progression or the results of treatment. Further studies and studies in larger patient groups are required in order to validate biomarkers as cost-effective tools in the AAA disease.
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SLC22A13 catalyses unidirectional efflux of aspartate and glutamate at the basolateral membrane of type A intercalated cells in the renal collecting duct. Biochem J 2013; 457:243-51. [DOI: 10.1042/bj20130654] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
SLC22A13 is specifically expressed in renal type A intercalated cells where it mediates the basolateral expulsion of aspartate and glutamate.
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Abstract
In the early 1930s, phenylketonuria was among the first metabolic diseases to be defined. In the following years, multiple attempts to correlate genotype and phenotype in several inherited metabolic diseases, including phenylketonuria, were encountered with difficulties. It is becoming evident that the phenotype of metabolic disorders is often more multifaceted than expected from the disruption of a specific enzyme function caused by a single-gene disorder. Undoubtedly, revealing the factors contributing to the discrepancy between the loss of a single enzymatic function and the wide spectrum of clinical consequences would allow clinicians to optimize treatment for their patients. This article discusses several possible contributors to the unique, complex phenotypes observed in inherited metabolic disorders, using argininosuccinic aciduria as a disease model.Genet Med 2013:15(4):251-257.
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Affiliation(s)
- Ayelet Erez
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.
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Nagamani SCS, Lee B, Erez A. Optimizing therapy for argininosuccinic aciduria. Mol Genet Metab 2012; 107:10-4. [PMID: 22841516 PMCID: PMC3444682 DOI: 10.1016/j.ymgme.2012.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 07/11/2012] [Accepted: 07/11/2012] [Indexed: 11/30/2022]
Abstract
Argininosuccinic aciduria (ASA) is a urea cycle disorder with a complex phenotype. In spite of a lower risk for recurrent hyperammonemic episodes as compared to the proximal disorders of ureagenesis, subjects with ASA are at risk for long-term complications including, poor neurocognitive outcome, hepatic disease and systemic hypertension. These complications can occur in spite of current standard therapy that includes dietary modifications and arginine supplementation suggesting that the presently available therapy is suboptimal. In this article, we discuss the natural history of ASA and the recent mechanistic insights from animal studies that have shown the requirement of argininosuccinate lyase, the enzyme deficient in ASA, for systemic nitric oxide production. These findings may have therapeutic implications and may help optimize therapy in ASA.
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Affiliation(s)
- Sandesh CS Nagamani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Howard Hughes Medical Institute, Houston, USA
- Corresponding author: Brendan Lee, M.D., Ph.D., Investigator, Howard Hughes Medical Institute, Professor, Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030., Phone: 713-798-5443, Fax: 713-798-5168,
| | - Ayelet Erez
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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Ciborowski M, Teul J, Martin-Ventura JL, Egido J, Barbas C. Metabolomics with LC-QTOF-MS permits the prediction of disease stage in aortic abdominal aneurysm based on plasma metabolic fingerprint. PLoS One 2012; 7:e31982. [PMID: 22384120 PMCID: PMC3286447 DOI: 10.1371/journal.pone.0031982] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 01/16/2012] [Indexed: 11/23/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is a permanent and localized aortic dilation, defined as aortic diameter ≥3 cm. It is an asymptomatic but potentially fatal condition because progressive enlargement of the abdominal aorta is spontaneously evolving towards rupture. Biomarkers may help to explain pathological processes of AAA expansion, and allow us to find novel therapeutic strategies or to determine the efficiency of current therapies. Metabolomics seems to be a good approach to find biomarkers of AAA. In this study, plasma samples of patients with large AAA, small AAA, and controls were fingerprinted with LC-QTOF-MS. Statistical analysis was used to compare metabolic fingerprints and select metabolites that showed a significant change. Results presented here reveal that LC-QTOF-MS based fingerprinting of plasma from AAA patients is a very good technique to distinguish small AAA, large AAA, and controls. With the use of validated PLS-DA models it was possible to classify patients according to the disease stage and predict properly the stage of additional AAA patients. Identified metabolites indicate a role for sphingolipids, lysophospholipids, cholesterol metabolites, and acylcarnitines in the development and progression of AAA. Moreover, guanidinosuccinic acid, which mimics nitric oxide in terms of its vasodilatory action, was found as a strong marker of large AAA.
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Affiliation(s)
- Michal Ciborowski
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
- Department of Physical Chemistry, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Teul
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
- Department of Pharmaceutical Analysis, Medical University of Bialystok, Bialystok, Poland
| | - Jose Luis Martin-Ventura
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Autónoma University, Madrid, Spain
| | - Jesús Egido
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Autónoma University, Madrid, Spain
| | - Coral Barbas
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain
- * E-mail:
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Abstract
The urea cycle consists of six consecutive enzymatic reactions that convert waste nitrogen into urea. Deficiencies of any of these enzymes of the cycle result in urea cycle disorders (UCDs), a group of inborn errors of hepatic metabolism that often result in life-threatening hyperammonemia. Argininosuccinate lyase (ASL) catalyzes the fourth reaction in this cycle, resulting in the breakdown of argininosuccinic acid to arginine and fumarate. ASL deficiency (ASLD) is the second most common UCD, with a prevalence of ~1 in 70,000 live births. ASLD can manifest as either a severe neonatal-onset form with hyperammonemia within the first few days after birth or as a late-onset form with episodic hyperammonemia and/or long-term complications that include liver dysfunction, neurocognitive deficits, and hypertension. These long-term complications can occur in the absence of hyperammonemic episodes, implying that ASL has functions outside of its role in ureagenesis and the tissue-specific lack of ASL may be responsible for these manifestations. The biochemical diagnosis of ASLD is typically established with elevation of plasma citrulline together with elevated argininosuccinic acid in the plasma or urine. Molecular genetic testing of ASL and assay of ASL enzyme activity are helpful when the biochemical findings are equivocal. However, there is no correlation between the genotype or enzyme activity and clinical outcome. Treatment of acute metabolic decompensations with hyperammonemia involves discontinuing oral protein intake, supplementing oral intake with intravenous lipids and/or glucose, and use of intravenous arginine and nitrogen-scavenging therapy. Dietary restriction of protein and dietary supplementation with arginine are the mainstays in long-term management. Orthotopic liver transplantation (OLT) is best considered only in patients with recurrent hyperammonemia or metabolic decompensations resistant to conventional medical therapy.
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Erez A, Nagamani SCS, Lee B. Argininosuccinate lyase deficiency-argininosuccinic aciduria and beyond. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2011; 157C:45-53. [PMID: 21312326 DOI: 10.1002/ajmg.c.30289] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The urea cycle consists of six consecutive enzymatic reactions that convert waste nitrogen into urea. Deficiencies of any of these enzymes of the cycle result in urea cycle disorders (UCD), a group of inborn errors of hepatic metabolism that often result in life threatening hyperammonemia. Argininosuccinate lyase (ASL) is a cytosolic enzyme which catalyzes the fourth reaction in the cycle and the first degradative step, that is, the breakdown of argininosuccinic acid to arginine and fumarate. Deficiency of ASL results in an accumulation of argininosuccinic acid in tissues, and excretion of argininosuccinic acid in urine leading to the condition argininosuccinic aciduria (ASA). ASA is an autosomal recessive disorder and is the second most common UCD. In addition to the accumulation of argininosuccinic acid, ASL deficiency results in decreased synthesis of arginine, a feature common to all UCDs except argininemia. Arginine is not only the precursor for the synthesis of urea and ornithine as part of the urea cycle but it is also the substrate for the synthesis of nitric oxide, polyamines, proline, glutamate, creatine, and agmatine. Hence, while ASL is the only enzyme in the body able to generate arginine, at least four enzymes use arginine as substrate: arginine decarboxylase, arginase, nitric oxide synthetase (NOS) and arginine/glycine aminotransferase. In the liver, the main function of ASL is ureagenesis, and hence, there is no net synthesis of arginine. In contrast, in most other tissues, its role is to generate arginine that is designated for the specific cell's needs. While patients with ASA share the acute clinical phenotype of hyperammonemia, encephalopathy, and respiratory alkalosis common to other UCD, they also present with unique chronic complications most probably caused by a combination of tissue specific deficiency of arginine and/or elevation of argininosuccinic acid. This review article summarizes the clinical characterization, biochemical, enzymatic, and molecular features of this disorder. Current treatment, prenatal diagnosis, diagnosis through the newborn screening as well as hypothesis driven future treatment modalities are discussed.
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Affiliation(s)
- Ayelet Erez
- Department of Molecular and Human, Genetics at Baylor College of Medicine, Houston, TX 77030, USA
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12
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Ciborowski M, Martin-Ventura JL, Meilhac O, Michel JB, Ruperez FJ, Tuñon J, Egido J, Barbas C. Metabolites Secreted by Human Atherothrombotic Aneurysms Revealed through a Metabolomic Approach. J Proteome Res 2011; 10:1374-82. [DOI: 10.1021/pr101138m] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Michal Ciborowski
- Centro de Excelencia en Metabolómica y Bioanálisis (CEMBIO), Faculty of Pharmacy, University San Pablo-CEU, Campus Montepríncipe, Boadilla del Monte, 28668 Madrid, Spain
- Department of Physical Chemistry, Medical University of Bialystok, Kilinskiego 1, 15-089 Bialystok, Poland
| | - Jose L. Martin-Ventura
- IIS-Vascular Research Laboratory, Fundación Jiménez Díaz, Madrid, Spain
- Autónoma University, Madrid, Spain
| | - Olivier Meilhac
- INSERM U698, Paris, F-75018, France; Université Denis Diderot, UMR-S698, Paris, F-75018, France
| | - Jean-Baptiste Michel
- INSERM U698, Paris, F-75018, France; Université Denis Diderot, UMR-S698, Paris, F-75018, France
| | - F. Javier Ruperez
- Centro de Excelencia en Metabolómica y Bioanálisis (CEMBIO), Faculty of Pharmacy, University San Pablo-CEU, Campus Montepríncipe, Boadilla del Monte, 28668 Madrid, Spain
| | - Jose Tuñon
- IIS-Vascular Research Laboratory, Fundación Jiménez Díaz, Madrid, Spain
- Autónoma University, Madrid, Spain
| | - Jesus Egido
- IIS-Vascular Research Laboratory, Fundación Jiménez Díaz, Madrid, Spain
- Autónoma University, Madrid, Spain
| | - Coral Barbas
- Centro de Excelencia en Metabolómica y Bioanálisis (CEMBIO), Faculty of Pharmacy, University San Pablo-CEU, Campus Montepríncipe, Boadilla del Monte, 28668 Madrid, Spain
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Abstract
Guanidinosuccinic acid is an aberrant metabolite isolated 40 years ago in the blood and urine of uremic subjects and a suspect in the toxicity associated with renal failure. It plays a minor role in the bleeding diathesis of uremia, contributes to the methyl group deficiency of dialysis patients, and is a factor in the premature atherosclerosis of end stage renal disease through the induction of hyperhomocysteinemia. As a major player, however, in the diversity and severity of uremic symptoms, it is a disappointment. Recently its source has been identified. It results from the superoxidation of argininosuccinic acid, which leads, also, to the production of gamma glutamic semialdehyde, an advanced glycation end product (AGE), which normally results from from the Maillard reaction, the non-enzymatic browning of protein. AGEs stimulate cross-linkages in protein that lead ultimately to loss of function, phagocytosis, and removal, and are important elements in the premature aging characteristic of renal disease, and diabetes.
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Affiliation(s)
- Burton D Cohen
- Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10469, USA.
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