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Shao X, Steiner R, Peterson AL. Newborn screening for lipid disorders. Curr Opin Lipidol 2024; 35:149-156. [PMID: 38408035 DOI: 10.1097/mol.0000000000000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW Newborn screening is one of the most successful public health programs of the last century and offers unparalleled access to universal screening for a variety of metabolic and other disorders. Interest in development of newborn screening for lipid disorders has intensified in recent years. Screening newborns for lipid disorders has important implications for the health of the newborn as well as their relatives, and in the case of more common lipid disorders like familial hypercholesterolemia, could have important public health implications. RECENT FINDINGS Recent studies have demonstrated feasibility of measuring biomarkers for heterozygous familial hypercholesterolemia from newborn screening dried blood spot specimens. Another lipid disorder, cerebrotendinous xanthomatosis, is currently amenable to newborn screening utilizing currently available assays. New research in next-generation sequencing as a primary screen in newborns will also identify both common and rare lipid disorders in newborns. SUMMARY Historically, newborn screening for lipid disorders was not done for many reasons, but new research has developed testing methods that may successfully identify common and rare lipid disorders. This will impact the health of the newborn but could also impact family members and public health.
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Affiliation(s)
- Xiangqiang Shao
- Department of Pediatrics, Division of Genetics and Metabolism
| | - Robert Steiner
- Department of Pediatrics, Division of Genetics and Metabolism
| | - Amy L Peterson
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health. Madison, Wisconsin, USA
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Gillberg C, Fernell E, Kočovská E, Minnis H, Bourgeron T, Thompson L, Allely CS. The role of cholesterol metabolism and various steroid abnormalities in autism spectrum disorders: A hypothesis paper. Autism Res 2017; 10:1022-1044. [PMID: 28401679 PMCID: PMC5485071 DOI: 10.1002/aur.1777] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 12/15/2016] [Accepted: 01/30/2017] [Indexed: 01/25/2023]
Abstract
Based on evidence from the relevant research literature, we present a hypothesis that there may be a link between cholesterol, vitamin D, and steroid hormones which subsequently impacts on the development of at least some of the "autisms" [Coleman & Gillberg]. Our hypothesis, driven by the peer reviewed literature, posits that there may be links between cholesterol metabolism, which we will refer to as "steroid metabolism" and findings of steroid abnormalities of various kinds (cortisol, testosterone, estrogens, progesterone, vitamin D) in autism spectrum disorder (ASD). Further research investigating these potential links is warranted to further our understanding of the biological mechanisms underlying ASD. Autism Res 2017. © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research. Autism Res 2017, 10: 1022-1044. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Eva Kočovská
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Barts and London School of Medicine, Queen Mary University of London, Blizard Institute58 Turner StreetE1 2ABLondon
| | - Helen Minnis
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Institute of Health and Wellbeing, University of Glasgow, RHSC YorkhillGlasgowScotlandG3 8SJUnited Kingdom
| | - Thomas Bourgeron
- Institut Pasteur, Human Genetics and Cognitive Functions UnitParisFrance
- CNRS UMR 3571: Genes, Synapses and Cognition, Institut PasteurParisFrance
- Université Paris Diderot, Sorbonne Paris CitéHuman Genetics and Cognitive FunctionsParisFrance
- FondaMental FoundationCréteilFrance
| | - Lucy Thompson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Institute of Health and Wellbeing, University of Glasgow, RHSC YorkhillGlasgowScotlandG3 8SJUnited Kingdom
| | - Clare S. Allely
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- School of Health SciencesUniversity of SalfordManchesterEngland
- Honorary Research Fellow in the College of MedicalVeterinary and Life Sciences affiliated to the Institute of Health and Wellbeing at the University of Glasgow
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LC–MS/MS-based quantification of cholesterol and related metabolites in dried blood for the screening of inborn errors of sterol metabolism. Anal Bioanal Chem 2015; 407:5227-33. [DOI: 10.1007/s00216-015-8731-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
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Gelzo M, Clericuzio S, Barone R, D'Apolito O, Dello Russo A, Corso G. A routine method for cholesterol and 7-dehydrocholesterol analysis in dried blood spot by GC-FID to diagnose the Smith-Lemli-Opitz syndrome. J Chromatogr B Analyt Technol Biomed Life Sci 2012; 907:154-8. [PMID: 22985726 DOI: 10.1016/j.jchromb.2012.08.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 08/16/2012] [Accepted: 08/21/2012] [Indexed: 12/28/2022]
Abstract
This work was aimed to implement a fast and simple method to quantify cholesterol (CHOL) and 7-dehydrocholesterol (7-DHC) in dried blood spot (DBS) to diagnose the Smith-Lemli-Opitz syndrome (SLOS), an inborn error of CHOL biosynthesis. We developed and validated a GC-FID method for separation and quantification of underivatized CHOL and 7-DHC using a DBS disc of 6mm with a run time of 9 min. Correlation coefficients (r) of calibration curves ranged from 0.998 to 0.999 for CHOL and from 0.997 to 0.998 for 7-DHC. Within-day and between-day imprecision (CV%), accuracy (%), carry-over, and extraction efficacy (%) were also evaluated for validation. CHOL and 7-DHC were analyzed in DBS and plasma samples from 8 SLOS patients and 30 unaffected subjects. In SLOS patients, 7-DHC/CHOL ratios in DBS and plasma samples ranged from 0.035 to 1.448 and from 0.012 to 0.926, respectively. Results from calibration curves, quality controls and patient samples reveal that the method is suitable to analyze DBS to screen patients affected by SLOS.
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Affiliation(s)
- Monica Gelzo
- Department of Biochemistry and Medical Biotechnologies, University Federico II of Naples, Naples, Italy
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Stability study of dehydrocholesterols in dried spot of blood from patients with Smith-Lemli-Opitz syndrome, using filter-paper treated with butylated hydroxytoluene. Clin Chim Acta 2011; 413:525-6. [PMID: 22120730 DOI: 10.1016/j.cca.2011.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 11/07/2011] [Accepted: 11/10/2011] [Indexed: 12/28/2022]
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Amaral C, Gallardo E, Rodrigues R, Pinto Leite R, Quelhas D, Tomaz C, Cardoso M. Quantitative analysis of five sterols in amniotic fluid by GC–MS: Application to the diagnosis of cholesterol biosynthesis defects. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:2130-6. [DOI: 10.1016/j.jchromb.2010.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 05/31/2010] [Accepted: 06/09/2010] [Indexed: 10/19/2022]
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Lakshmy R, Gupta R, Prabhakaran D, Snehi U, Reddy KS. Utility of dried blood spots for measurement of cholesterol and triglycerides in a surveillance study. J Diabetes Sci Technol 2010; 4:258-62. [PMID: 20307386 PMCID: PMC2864161 DOI: 10.1177/193229681000400206] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Developing countries are facing a rise in noncommunicable diseases (NCD), which is a cause for concern. The World Health Organization has recommended a stepwise approach for NCD risk factor surveillance. Screening for risk factors in remote populations is difficult due to lack of resources and technical expertise, including standardized laboratory facilities. The collection of samples on filter paper for the assessment of risk factors circumvents the need for blood processing, storage, and shipment at ultralow temperatures. METHOD Samples were collected on 3-mm Whatman filter paper from one industry (National Thermal Power Corporation) located in the periphery of Delhi as part of a surveillance carried out in industries from different parts of India. Total cholesterol was measured in serum and dried blood by the cholesterol oxidase/p-aminophenazone method and triglycerides by the glycerophosphate oxidase-peroxidase/aminophenazone method. Values obtained by the two methods were compared using Pearson correlation, and Bland-Altman plots were prepared to assess bias. RESULTS The correlation coefficient "r" was 0.78 for cholesterol and 0.94 for triglycerides between dried blood spots and serum. Bland-Altman plots suggest that differences in values obtained by the two methods were within two standard deviations for most of the samples. CONCLUSIONS Blood samples dried on filter paper can be a successful option for population screening in remote areas, provided preanalytical variations arising due to the method of blood spot preparation and storage are well controlled.
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Affiliation(s)
- Ramakrishnan Lakshmy
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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Griffiths WJ, Wang Y. Sterol lipidomics in health and disease: Methodologies and applications. EUR J LIPID SCI TECH 2009. [DOI: 10.1002/ejlt.200800116] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Griffiths WJ, Wang Y, Karu K, Samuel E, McDonnell S, Hornshaw M, Shackleton C. Potential of sterol analysis by liquid chromatography-tandem mass spectrometry for the prenatal diagnosis of Smith-Lemli-Opitz syndrome. Clin Chem 2008; 54:1317-24. [PMID: 18556335 DOI: 10.1373/clinchem.2007.100644] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Smith-Lemli-Opitz syndrome (SLOS), a severe disorder of cholesterol synthesis, is classically diagnosed prenatally by GC-MS analysis of sterols in amniotic fluid. Considering the current trend toward tandem mass spectrometry (MS/MS) methodologies, we developed prototype LC-MS/MS methods for accurate diagnosis of the disorder. METHODS 3beta-Hydroxysterols in amniotic fluid are oxidized with cholesterol oxidase to their corresponding 3-ketones, which are then derivatized with Girard P (GP) hydrazine in a "one-pot" reaction. The resulting GP-hydrazones give an improved response in electrospray (ES)-MS/MS owing to the presence of a charged quaternary nitrogen and are analyzed by reversed-phase LC-ES-MS/MS. Both capillary and conventional LC-MS/MS formats are suitable, and the method is also applicable to paper-absorbed blood spots. RESULTS In a double-blind analysis of 18 amniotic fluid samples comprising 6 SLOS and 12 controls, the ratio of 7 + 8-dehydrocholesterol (7 + 8-DHC) to cholesterol was <0.02 [range 0.00-0.02, mean (SD) 0.01 (0.007)] in all control samples (intraassay variation 5.91%) and >0.20 [0.20-1.13, 0.79 (0.35)] in SLOS (intraassay variation 4.56%), corresponding to a difference in ratios between the 2 groups of at least a factor of 10. The limit of quantification was equivalent to that of 2 nL amniotic fluid injected on-column. CONCLUSIONS We describe a proof-of-concept for the prenatal diagnosis of SLOS. Further developments will be necessary to automate sample handling and reduce chromatographic time for the methodology to be used in pre- and postnatal diagnosis.
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Affiliation(s)
- William J Griffiths
- Institute of Mass Spectrometry, School of Medicine, Swansea University, Swansea, UK.
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Cardoso ML, Balreira A, Martins E, Nunes L, Cabral A, Marques M, Lima MR, Marques JS, Medeira A, Cordeiro I, Pedro S, Mota MC, Dionisi-Vici C, Santorelli FM, Jakobs C, Clayton PT, Vilarinho L. Molecular studies in Portuguese patients with Smith-Lemli-Opitz syndrome and report of three new mutations in DHCR7. Mol Genet Metab 2005; 85:228-35. [PMID: 15979035 DOI: 10.1016/j.ymgme.2005.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Revised: 02/16/2005] [Accepted: 02/16/2005] [Indexed: 10/25/2022]
Abstract
Smith-Lemli-Opitz syndrome (SLO) is an autosomal recessive disorder characterised by craniofacial dysmorphism, mental retardation, multiple congenital anomalies, and increased levels of 7-dehydrocholesterol (7-DHC) in body tissues and fluids. SLO is caused by mutations in the DHCR7 gene which encodes 7-dehydrocholesterol reductase, the last enzyme of cholesterol biosynthesis pathway. In our investigation, we screened 682 dysmorphic/mentally retarded Portuguese patients for abnormal levels of 7-DHC in blood by UV spectrometry. We identified six unrelated patients with SLO (0.87% of total). Mutational analysis of the DHCR7 gene led to the identification of seven distinct mutations, three of which are new (F174S, H301R, and Q98X). The common IVS8-1G > C and T93M variants together with the H301R accounted for 70% of the all SLO alleles in our population. Our findings contribute to the variegate array of pathological changes in the DHCR7 gene among different European populations.
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Affiliation(s)
- M L Cardoso
- Instituto de Genética Médica Jacinto de Magalhães, Oporto, Portugal
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Starck L, Lövgren-Sandblom A, Björkhem I. Simvastatin treatment in the SLO syndrome: a safe approach? AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 113:183-9. [PMID: 12407710 DOI: 10.1002/ajmg.10722] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Soon after the discovery of reduced cholesterol synthesis in the Smith-Lemli-Opitz syndrome (SLOS), several trials with dietary supplementation were initiated with the aim of increasing cholesterol and reducing the de novo synthesis and accumulation of 7- and 8-dehydrocholesterol (DHC). Dietary cholesterol raises cholesterol levels in the circulation with only marginal effects on levels of DHC. Photosensitivity and polyneuropathy have been reported to be improved by the treatment, but other effects have been difficult to evaluate. In order to see whether inhibition of hydroxymethylglutaryl CoA reductase is of benefit, two of our patients have been treated with simvastatin in addition to the long-term treatment with cholesterol and bile acids. Absolute as well as relative levels of DHC were reduced. In one patient, creatine kinase increased moderately after 2 months of treatment. In the other patient, the treatment had to be interrupted because of hepatotoxic side effects with a marked increase in alanine aminotransferase and aggravation of the hypocholesterolemia and photosensitivity. We conclude that even if the levels of accumulated intermediates can be reduced, treatment with a statin may be harmful in some patients with SLOS.
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Affiliation(s)
- Lena Starck
- Sachs' Children's Hospital, Department of Paediatrics, Karolinska Institute, Stockholm, Sweden.
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Xiong Q, Ruan B, Whitby FG, Tuohy RP, Belanger TL, Kelley RI, Wilson WK, Schroepfer GJ. A colorimetric assay for 7-dehydrocholesterol with potential application to screening for Smith-Lemli-Opitz syndrome. Chem Phys Lipids 2002; 115:1-15. [PMID: 12047895 DOI: 10.1016/s0009-3084(01)00205-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Smith-Lemli-Opitz syndrome (SLOS; MIM 270400) is a genetic disorder characterized by hypocholesterolemia and elevated 7-dehydrocholesterol (7DHC) levels resulting from mutations affecting 7-dehydrocholesterol reductase. We describe a colorimetric assay for 7DHC with potential application to large-scale screening for SLOS. Reaction of 7DHC and its esters with the Liebermann-Burchard reagent resulted in a brief initial absorbance at 510 nm (pink color) followed by an absorbance at 620 nm (blue color) after 2 min, while cholesterol samples were essentially colorless. The assay could identify typical SLOS blood samples by their pink color and increased absorbance at 620 nm after 2 min. Colorimetric identification of mild SLOS cases requires monitoring of the transient absorbance at 510 nm, which must be detected immediately after rapid, consistent mixing of the reagents. The need for special mixing devices and rigorous validation precludes sporadic use of the assay for diagnosing suspected SLOS cases. We also studied the stability of 7DHC in dried SLOS blood spots on Guthrie cards, which are widely used for archiving neonatal blood. Decomposition of 7DHC was effectively retarded by storage at low temperature and by precoating of the cards with antioxidants. The combined results provide a foundation for development of a simple, automated test for SLOS screening.
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Affiliation(s)
- Quanbo Xiong
- Department of Biochemistry and Cell Biology, Rice University, MS140, 6100 Main Street, Houston, TX 77005-1892, USA
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Johnson D, ten Brink H, Jakobs C. A rapid screening procedure for cholesterol and dehydrocholesterol by electrospray ionization tandem mass spectrometry. J Lipid Res 2001. [DOI: 10.1016/s0022-2275(20)32225-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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