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Oliva C, Arias A, Ruiz-Sala P, Garcia-Villoria J, Carling R, Bierau J, Ruijter GJG, Casado M, Ormazabal A, Artuch R. Targeted ultra performance liquid chromatography tandem mass spectrometry procedures for the diagnosis of inborn errors of metabolism: validation through ERNDIM external quality assessment schemes. Clin Chem Lab Med 2024; 0:cclm-2023-1291. [PMID: 38456798 DOI: 10.1515/cclm-2023-1291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Early diagnosis of inborn errors of metabolism (IEM) is crucial to ensure early detection of conditions which are treatable. This study reports on targeted metabolomic procedures for the diagnosis of IEM of amino acids, acylcarnitines, creatine/guanidinoacetate, purines/pyrimidines and oligosaccharides, and describes its validation through external quality assessment schemes (EQA). METHODS Analysis was performed on a Waters ACQUITY UPLC H-class system coupled to a Waters Xevo triple-quadrupole (TQD) mass spectrometer, operating in both positive and negative electrospray ionization mode. Chromatographic separation was performed on a CORTECS C18 column (2.1 × 150, 1.6 µm). Data were collected by multiple reaction monitoring. RESULTS The internal and EQA results were generally adequate, with a few exceptions. We calculated the relative measurement error (RME) and only a few metabolites displayed a RME higher than 30 % (asparagine and some acylcarnitine species). For oligosaccharides, semi-quantitative analysis of an educational panel clearly identified the 8 different diseases included. CONCLUSIONS Overall, we have validated our analytical system through an external quality control assessment. This validation will contribute to harmonization between laboratories, thus improving identification and management of patients with IEM.
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Affiliation(s)
- Clara Oliva
- Biochemistry and Molecular Genetics Department, 571524 Hospital Clínic de Barcelona , Barcelona, Spain
| | - Angela Arias
- Clinical Biochemistry Department, 16512 Institut de Recerca Sant Joan de Déu , Barcelona, Spain
| | - Pedro Ruiz-Sala
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Diagnóstico de Enfermedades Moleculares, Universidad Autónoma de Madrid, IdIPAZ, Madrid, Spain
| | - Judit Garcia-Villoria
- Biochemistry and Molecular Genetics Department, 571524 Hospital Clínic de Barcelona , Barcelona, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Rachel Carling
- Department of Biochemical Sciences, 8945 Synnovis, Guy's & St Thomas' NHSFT , London, UK
| | - Jörgen Bierau
- Department of Clinical Genetics, 570888 Maastricht University Medical Center , Maastricht, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - George J G Ruijter
- Center for Lysosomal and Metabolic Diseases, Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mercedes Casado
- Clinical Biochemistry Department, 16512 Institut de Recerca Sant Joan de Déu , Barcelona, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Ormazabal
- Clinical Biochemistry Department, 16512 Institut de Recerca Sant Joan de Déu , Barcelona, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Artuch
- Clinical Biochemistry Department, 16512 Institut de Recerca Sant Joan de Déu , Barcelona, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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Efficacy and pharmacokinetics of betaine in CBS and cblC deficiencies: a cross-over randomized controlled trial. Orphanet J Rare Dis 2022; 17:417. [PMID: 36376887 PMCID: PMC9664596 DOI: 10.1186/s13023-022-02567-4] [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: 07/01/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Betaine is an "alternate" methyl donor for homocysteine remethylation catalyzed by betaine homocysteine methyltransferase (BHMT), an enzyme mainly expressed in the liver and kidney. Betaine has been used for more than 30 years in pyridoxine non-responsive cystathionine beta-synthase (pnrCBS) and cobalamin C (cblC) deficiencies to lower the hyperhomocysteinemia, although little is known about the optimal therapeutic dosage and its pharmacokinetic in these patients. AIMS We compared 2 betaine doses (100 mg/kg/day vs. 250 mg/kg/day) in children affected by pnrCBS or cblC deficiencies. We also measured the pharmacokinetics parameters after a single dose of betaine (100 or 250 mg/kg) in these patients. METHODS We conducted a prospective, randomized, crossover clinical trial with blinded evaluation. The primary outcome was the equivalence of total plasma homocysteine (tHcy) concentrations upon one-month oral treatment with betaine at 100 versus 250 mg/kg/day. RESULTS Eleven patients completed the study (5 pnrCBS and 6 cblC). tHcy concentrations were equivalent after a one-month treatment period for the two betaine dosages. Multivariate analysis showed a significant effect of betaine dose on methionine (Met) (p = 0.01) and S-adenosylmethionine (SAM) concentrations (p = 0.006). CONCLUSIONS Our analysis shows that there is no overt benefit to increasing betaine dosage higher than 100 mg/kg/day to lower tHcy concentrations in pnrCBS and cblC deficiencies. However, increasing betaine up to 250 mg/kg/d could benefit cblC patients through the increase of methionine and SAM concentrations, as low Met and SAM concentrations are involved in the pathophysiology of this disease. In contrast, in pnrCBS deficiency, betaine doses higher than 100 mg/kg/day could be harmful to these patients with pre-existing hypermethioninemia. TRIAL REGISTRATION Clinical Trials, NCT02404337. Registered 23 May 2015-prospectively registered, https://clinicaltrials.gov .
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3
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Sukhang M, Junkuy A, Buckley N, Mohamed F, Wunnapuk K. An LC-MS/MS method for creatine and creatinine analysis in paraquat-intoxicated patients. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2019; 55:273-282. [PMID: 31744381 DOI: 10.1080/03601234.2019.1690342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A sudden increase in serum creatinine after paraquat intoxication has been reported in several clinical studies. However, this dramatic change of creatinine may be possibly due to an interconversion of creatine-creatinine in relation to paraquat toxicity. In order to investigate the creatine-creatinine relationship, a liquid chromatography tandem mass spectrometry in combination with electrospray ionization was developed and validated for simultaneous determination of creatine and creatinine in the serum. The chromatographic separation was achieved on a Gemini® C6-Phenyl column with a gradient elution consisting of 0.1% formic acid in ultrapure water and methanol as the mobile phase. The method yielded suitable levels of specificity and selectivity, and calibration curves of creatine and creatinine in serum were linear over the concentration range of 0.5-200 µg mL-1. The limit of quantification of both compounds was 0.5 µg mL-1, and the method was accurate within the recovery range of 96.23-102.75%, indicating the robustness of the method. The method was successfully applied to toxicological samples from paraquat-intoxicated patients, and the concentrations of creatine and creatinine were quantified. High creatine concentrations in serum samples were observed which may lead to high serum creatinine despite normal kidney function as creatine is converted to creatinine in proportion to its concentration.
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Affiliation(s)
- Mukdawan Sukhang
- Toxicology Unit, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Anongphan Junkuy
- Toxicology Unit, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicholas Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Klintean Wunnapuk
- Toxicology Unit, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Zhang H, Mao Z, Huang K, Wang X, Cheng L, Zeng L, Zhou Y, Jing T. Multiple exposure pathways and health risk assessment of heavy metal(loid)s for children living in fourth-tier cities in Hubei Province. ENVIRONMENT INTERNATIONAL 2019; 129:517-524. [PMID: 31158597 DOI: 10.1016/j.envint.2019.04.031] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/19/2019] [Accepted: 04/12/2019] [Indexed: 06/09/2023]
Abstract
In the past, most research focused on the children living near a typical contaminated area but ignored the health risks of children living in the fourth or fifth tier cities without typical contaminated sources. These cities are now facing a series of problems, such as serious environmental pollution, undeveloped health system and so on. Furthermore, the development of modern logistics for food delivery has altered lifestyles that directly impact diets and eating patterns. In this study, multiple exposure pathways and health risks of children to heavy metal(loid)s were studied based on questionnaire-based surveys and field sampling of soil, dust, fine particulates, drinking water and food. We found that Pb, Cd and Mn levels in environmental samples were very high indicating a serious pollution problem. Inhalation exposure via aerosol particles was the most important pathway and was greater than exposure by food ingestion. The hazard index for Mn via aerosol particles was >1 even at the 5th percentile and Mn levels in urine was 10 times higher than those of people living in typical contaminated areas. The total incremental lifetime cancer risk (ILCR) for all metal(loid)s was also higher than the threshold at the 95th percentile. This study highlights health risks to children living in fourth tier cities and the importance of air pollution control to protect heavy metal exposure for children.
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Affiliation(s)
- Hongxing Zhang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Kai Huang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Xiu Wang
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Ling Cheng
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Lingshuai Zeng
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Yikai Zhou
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China
| | - Tao Jing
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei 430030, China.
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Tao D, Leister W, Huang W, Alimardanov A, LeClair CA. Facile High-Performance Liquid Chromatography Mass Spectrometry Method for Analysis of Cyclocreatine and Phosphocyclocreatine in Complex Mixtures of Amino Acids. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:7190-7196. [PMID: 31194545 PMCID: PMC7045947 DOI: 10.1021/acs.jafc.9b01878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Creatine transporter deficiency (CTD) is caused by a defect in the X-linked creatine transporter SLC6A8 gene leading to severe neurologic and physiologic conditions. Cyclocreatine and phosphocyclocreatine supplementation is seen as a potential treatment, but the presence of these compounds within commercially available dietary supplements presents the risk of self-medication. High-performance liquid chromatography-mass spectrometry (HPLC-MS) is an excellent technique to assess composition of complex amino acid mixtures. Herein, we have developed a facile HPLC-MS method using a cyano column in hydrophilic interaction liquid chromatography (HILIC) mode with isocratic elution over 4 min to identify the main components of two commercially available dietary supplements. The relative standard deviation (RSD) for retention time and extracted ion integrated area are <0.3% and 4%, respectively, showing excellent reproducibility. Cyclocreatine and phosphocyclocreatine were not detectable within the dietary supplements, even at ppm levels, demonstrating the power and importance of the developed HPLC-MS method in analyzing complex mixtures.
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Affiliation(s)
- Dingyin Tao
- Corresponding authors: Dr. Dingyin Tao,
; and Dr. Christopher A. LeClair,
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6
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Hydrophilic interaction chromatography coupled to tandem mass spectrometry as a method for simultaneous determination of guanidinoacetate and creatine. Anal Chim Acta 2018; 1028:96-103. [PMID: 29884358 DOI: 10.1016/j.aca.2018.03.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/16/2018] [Accepted: 03/19/2018] [Indexed: 12/19/2022]
Abstract
The biosynthesis of creatine (Cr) is closely related to the bioavailability of guanidinoacetate (GAA). The lack of one or the other may compromise their role in the energy transport and cell signaling. A reliable estimate of their levels in biological samples is imperative since they are important markers of many metabolic disorders. Therefore, a new LC-MS/MS method for simultaneous determination and quantification of GAA and Cr by multiple reaction monitoring (MRM) mode was developed based on the hydrophilic interaction chromatography (HILIC) and response surface methodology (RSM) for the optimization of chromatographic parameters. The optimized parameters ensured good separation of these similar, very polar molecules (chromatographic resolution > 1.5) without prior derivatization step in a short analysis run (6 min). The developed method was validated to ensure accurate (R, 75.1-101.6%), precise (RSD < 20%) and low quantification (LOQ of 0.025 μg mL-1 for GAA and 0.006 μg mL-1 for Cr) of the tested analytes and the use of matrix-matched calibration eliminated variable effects of complex matrices such as human plasma and urine. Therefore, this method can be implemented in medical laboratories as a tool for the diagnostics of creatine deficiencies and monitoring of guanidinoacetate and creatine supplementation regimes in biological samples.
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7
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Joncquel-Chevalier Curt M, Bout MA, Fontaine M, Kim I, Huet G, Bekri S, Morin G, Moortgat S, Moerman A, Cuisset JM, Cheillan D, Vamecq J. Functional assessment of creatine transporter in control and X-linked SLC6A8-deficient fibroblasts. Mol Genet Metab 2018; 123:463-471. [PMID: 29478817 DOI: 10.1016/j.ymgme.2018.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 01/01/2023]
Abstract
Creatine transporter is currently the focus of renewed interest with emerging roles in brain neurotransmission and physiology, and the bioenergetics of cancer metastases. We here report on amendments of a standard creatine uptake assay which might help clinical chemistry laboratories to extend their current range of measurements of creatine and metabolites in body fluids to functional enzyme explorations. In this respect, short incubation times and the use of a stable-isotope-labeled substrate (D3-creatine) preceded by a creatine wash-out step from cultured fibroblast cells by removal of fetal bovine serum (rich in creatine) from the incubation medium are recommended. Together, these measures decreased, by a first order of magnitude, creatine concentrations in the incubation medium at the start of creatine-uptake studies and allowed to functionally discriminate between 4 hemizygous male and 4 heterozygous female patients with X-linked SLC6A8 deficiency, and between this cohort of eight patients and controls. The functional assay corroborated genetic diagnosis of SLC6A8 deficiency. Gene anomalies in our small cohort included splicing site (c.912G > A [p.Ile260_Gln304del], c.778-2A > G and c.1495 + 2 T > G), substitution (c.407C > T) [p.Ala136Val] and deletion (c.635_636delAG [p.Glu212Valfs*84] and c.1324delC [p.Gln442Lysfs*21]) variants with reduced creatine transporter function validating their pathogenicity, including that of a previously unreported c.1324delC variant. The present assay adaptations provide an easy, reliable and discriminative manner for exploring creatine transporter activity and disease variations. It might apply to drug testing or other evaluations in the genetic and metabolic horizons covered by the emerging functions of creatine and its transporter, in a way, however, requiring and completed by additional studies on female patients and blood-brain barrier permeability properties of selected compounds. As a whole, the proposed assay of creatine transporter positively adds to currently existing measurements of this transporter activity, and determining on a large scale the extent of its exact suitability to detect female patients should condition in the future its transfer in clinical practice.
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MESH Headings
- Adolescent
- Brain Diseases, Metabolic, Inborn/genetics
- Brain Diseases, Metabolic, Inborn/metabolism
- Brain Diseases, Metabolic, Inborn/pathology
- Case-Control Studies
- Child
- Child, Preschool
- Cohort Studies
- Creatine/deficiency
- Creatine/genetics
- Creatine/metabolism
- Female
- Fibroblasts/metabolism
- Fibroblasts/pathology
- Follow-Up Studies
- Humans
- Infant
- Male
- Mental Retardation, X-Linked/genetics
- Mental Retardation, X-Linked/metabolism
- Mental Retardation, X-Linked/pathology
- Mutation
- Nerve Tissue Proteins/deficiency
- Nerve Tissue Proteins/genetics
- Plasma Membrane Neurotransmitter Transport Proteins/deficiency
- Plasma Membrane Neurotransmitter Transport Proteins/genetics
- Plasma Membrane Neurotransmitter Transport Proteins/metabolism
- Prognosis
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Affiliation(s)
- Marie Joncquel-Chevalier Curt
- Department of Biochemistry and Molecular Biology, Laboratory of Hormonology, Metabolism-Nutrition & Oncology (HMNO), Center of Biology and Pathology (CBP) Pierre-Marie Degand, CHRU, Lille, France
| | - Marie-Adélaïde Bout
- Department of Biochemistry and Molecular Biology, Laboratory of Hormonology, Metabolism-Nutrition & Oncology (HMNO), Center of Biology and Pathology (CBP) Pierre-Marie Degand, CHRU, Lille, France
| | - Monique Fontaine
- Department of Biochemistry and Molecular Biology, Laboratory of Hormonology, Metabolism-Nutrition & Oncology (HMNO), Center of Biology and Pathology (CBP) Pierre-Marie Degand, CHRU, Lille, France
| | - Isabelle Kim
- Department of Biochemistry and Molecular Biology, Laboratory of Hormonology, Metabolism-Nutrition & Oncology (HMNO), Center of Biology and Pathology (CBP) Pierre-Marie Degand, CHRU, Lille, France
| | - Guillemette Huet
- Cell Culture Department, Center of Biology-Pathology, CHRU Lille, F-59000 Lille, France
| | - Soumeya Bekri
- Inserm U1245, UNIROUEN, Normandie Univ, Normandy Centre for Genomic and Personalized Medicine, France.Department of Metabolic Biochemistry, Rouen University Hospital, Rouen, France
| | - Gilles Morin
- EA 4666, Département de génétique, Université de Picardie-Jules-Verne, CHU d'Amiens, 80054 Amiens, France
| | - Stéphanie Moortgat
- Centre de Génétique Humaine, Institut de Pathologie et de Génétique, Charleroi, Gosselies, Belgium
| | - Alexandre Moerman
- Service de Génétique Clinique Guy Fontaine, Hôpital Jeanne de Flandre, CHRU Lille, 59037 Lille, France
| | - Jean-Marie Cuisset
- Service de Neurologie Infantile, Hôpital Roger Salengro, CHRU Lille, 59037 Lille, France
| | - David Cheillan
- Hospices Civils de Lyon, Service de Biochimie et Biologie Moléculaire Grand Est, Centre de Biologie et de Pathologie Est, 69677 Bron, France and Université de Lyon, INSERM U1060, CarMen; Medical Reference Center for Inherited Metabolic Diseases, Jeanne de Flandre Hospital, CHRU Lille, France
| | - Joseph Vamecq
- Department of Biochemistry and Molecular Biology, Laboratory of Hormonology, Metabolism-Nutrition & Oncology (HMNO), Center of Biology and Pathology (CBP) Pierre-Marie Degand, CHRU, Lille, France; Inserm, Lille, France; Université de Lyon, INSERM U1060 CarMeN, Lyon, France.; Univ. Lille, RADEME - Maladies RAres du Développement et du Métabolisme : du phénotype au génotype et à la Fonction, Lille, EA 7364, France.
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8
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Changing to a vegetarian diet reduces the body creatine pool in omnivorous women, but appears not to affect carnitine and carnosine homeostasis: a randomised trial. Br J Nutr 2018; 119:759-770. [DOI: 10.1017/s000711451800017x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AbstractBalanced vegetarian diets are popular, although they are nearly absent in creatine and carnosine and contain considerably less carnitine than non-vegetarian diets. Few longitudinal intervention studies investigating the effect of a vegetarian diet on the availability of these compounds currently exist. We aimed to investigate the effect of transiently switching omnivores onto a vegetarian diet for 6 months on muscle and plasma creatine, carnitine and carnosine homeostasis. In a 6-month intervention, forty omnivorous women were ascribed to three groups: continued omnivorous diet (control,n10), vegetarian diet without supplementation (Veg+Pla,n15) and vegetarian diet combined with dailyβ-alanine (0·8–0·4 g/d) and creatine supplementation (1 g creatine monohydrate/d) (Veg+Suppl,n15). Before (0 months; 0M), after 3 months (3M) and 6 months (6M), a fasted venous blood sample and 24-h urine was collected, and muscle carnosine content was determined by proton magnetic resonance spectroscopy (1H-MRS). Muscle biopsies were obtained at 0M and 3M. Plasma creatine and muscle total creatine content declined from 0M to 3M in Veg+Pla (P=0·013 andP=0·009, respectively), whereas plasma creatine increased from 0M in Veg+Suppl (P=0·004). None of the carnitine-related compounds in plasma or muscle showed a significant time×group interaction effect.1H-MRS-determined muscle carnosine content was unchanged over 6M in control and Veg+Pla, but increased in Veg+Suppl in soleus (P<0·001) and gastrocnemius (P=0·001) muscle. To conclude, the body creatine pool declined over a 3-month vegetarian diet in omnivorous women, which was ameliorated when accompanied by low-dose dietary creatine supplementation. Carnitine and carnosine homeostasis was unaffected by a 3- or 6-month vegetarian diet, respectively.
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9
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High-throughput screening and quantitation of guanidino and ureido compounds using liquid chromatography-drift tube ion mobility spectrometry-mass spectrometry. Anal Chim Acta 2017; 961:82-90. [DOI: 10.1016/j.aca.2017.01.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/17/2017] [Accepted: 01/25/2017] [Indexed: 11/20/2022]
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10
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Rackayova V, Cudalbu C, Pouwels PJW, Braissant O. Creatine in the central nervous system: From magnetic resonance spectroscopy to creatine deficiencies. Anal Biochem 2016; 529:144-157. [PMID: 27840053 DOI: 10.1016/j.ab.2016.11.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/08/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
Abstract
Creatine (Cr) is an important organic compound acting as intracellular high-energy phosphate shuttle and in energy storage. While located in most cells where it plays its main roles in energy metabolism and cytoprotection, Cr is highly concentrated in muscle and brain tissues, in which Cr also appears to act in osmoregulation and neurotransmission. This review discusses the basis of Cr metabolism, synthesis and transport within brain cells. The importance of Cr in brain function and the consequences of its impaired metabolism in primary and secondary Cr deficiencies are also discussed. Cr and phosphocreatine (PCr) in living systems can be well characterized using in vivo magnetic resonance spectroscopy (MRS). This review describes how 1H MRS allows the measurement of Cr and PCr, and how 31P MRS makes it possible to estimate the creatine kinase (CK) rate constant and so detect dynamic changes in the Cr/PCr/CK system. Absolute quantification by MRS using creatine as internal reference is also debated. The use of in vivo MRS to study brain Cr in a non-invasive way is presented, as well as its use in clinical and preclinical studies, including diagnosis and treatment follow-up in patients.
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Affiliation(s)
- Veronika Rackayova
- Laboratory of Functional and Metabolic Imaging (LIFMET), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Cristina Cudalbu
- Centre d'Imagerie Biomedicale (CIBM), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Petra J W Pouwels
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Olivier Braissant
- Service of Biomedicine, Neurometabolic Unit, Lausanne University Hospital, Lausanne, Switzerland.
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Dhayat N, Simonin A, Anderegg M, Pathare G, Lüscher BP, Deisl C, Albano G, Mordasini D, Hediger MA, Surbek DV, Vogt B, Sass JO, Kloeckener-Gruissem B, Fuster DG. Mutation in the Monocarboxylate Transporter 12 Gene Affects Guanidinoacetate Excretion but Does Not Cause Glucosuria. J Am Soc Nephrol 2016; 27:1426-36. [PMID: 26376857 PMCID: PMC4849831 DOI: 10.1681/asn.2015040411] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/05/2015] [Indexed: 01/08/2023] Open
Abstract
A heterozygous mutation (c.643C>A; p.Q215X) in the monocarboxylate transporter 12-encoding gene MCT12 (also known as SLC16A12) that mediates creatine transport was recently identified as the cause of a syndrome with juvenile cataracts, microcornea, and glucosuria in a single family. Whereas the MCT12 mutation cosegregated with the eye phenotype, poor correlation with the glucosuria phenotype did not support a pathogenic role of the mutation in the kidney. Here, we examined MCT12 in the kidney and found that it resides on basolateral membranes of proximal tubules. Patients with MCT12 mutation exhibited reduced plasma levels and increased fractional excretion of guanidinoacetate, but normal creatine levels, suggesting that MCT12 may function as a guanidinoacetate transporter in vivo However, functional studies in Xenopus oocytes revealed that MCT12 transports creatine but not its precursor, guanidinoacetate. Genetic analysis revealed a separate, undescribed heterozygous mutation (c.265G>A; p.A89T) in the sodium/glucose cotransporter 2-encoding gene SGLT2 (also known as SLC5A2) in the family that segregated with the renal glucosuria phenotype. When overexpressed in HEK293 cells, the mutant SGLT2 transporter did not efficiently translocate to the plasma membrane, and displayed greatly reduced transport activity. In summary, our data indicate that MCT12 functions as a basolateral exit pathway for creatine in the proximal tubule. Heterozygous mutation of MCT12 affects systemic levels and renal handling of guanidinoacetate, possibly through an indirect mechanism. Furthermore, our data reveal a digenic syndrome in the index family, with simultaneous MCT12 and SGLT2 mutation. Thus, glucosuria is not part of the MCT12 mutation syndrome.
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Affiliation(s)
- Nasser Dhayat
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland
| | - Alexandre Simonin
- Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and
| | - Manuel Anderegg
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland; Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and
| | - Ganesh Pathare
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland; Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and
| | - Benjamin P Lüscher
- Department of Clinical Research, University of Bern, Switzerland; Swiss National Centre of Competence in Research Transcure, and Department of Obstetrics and Gynecology, University Hospital of Bern, Switzerland
| | - Christine Deisl
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland; Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and
| | - Giuseppe Albano
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland; Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and
| | - David Mordasini
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland
| | - Matthias A Hediger
- Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and Department of Obstetrics and Gynecology, University Hospital of Bern, Switzerland
| | - Daniel V Surbek
- Department of Clinical Research, University of Bern, Switzerland; Swiss National Centre of Competence in Research Transcure, and Department of Obstetrics and Gynecology, University Hospital of Bern, Switzerland
| | - Bruno Vogt
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland
| | - Jörn Oliver Sass
- Division of Clinical Chemistry and Biochemistry, Children's Research Center, University Children's Hospital, Zürich, Switzerland; Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, Rheinbach, Germany
| | - Barbara Kloeckener-Gruissem
- Institute of Medical Molecular Genetics, University of Zürich, Zürich, Switzerland; and Department of Biology, Swiss Federal Institute of Technology in Zürich, Zürich, Switzerland
| | - Daniel G Fuster
- Division of Nephrology, Hypertension and Clinical Pharmacology, and Department of Clinical Research, University of Bern, Switzerland; Institute of Biochemistry and Molecular Medicine, Swiss National Centre of Competence in Research Transcure, and
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Fan RJ, Guan Q, Zhang F, Leng JP, Sun TQ, Guo YL. Benzylic rearrangement stable isotope labeling for quantitation of guanidino and ureido compounds in thyroid tissues by liquid chromatography-electrospray ionization mass spectrometry. Anal Chim Acta 2016; 908:132-40. [PMID: 26826695 DOI: 10.1016/j.aca.2015.12.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/18/2015] [Accepted: 12/20/2015] [Indexed: 12/18/2022]
Abstract
Benzylic rearrangement stable isotope labeling (BRSIL) was explored to quantify the guanidino and ureido compounds (GCs and UCs). This method employed a common reagent, benzil, to label the guanidino and ureido groups through nucleophilic attacking then benzylic migrating. The use of BRSIL was investigated in the analysis of five GCs (creatine, l-arginine, homoarginine, 4-guanidinobutyric acid, and methylguanidine) and two UCs (urea and citrulline). The labeling was found simple and specific. The introduction of bi-phenyl group and the generation of nitrogen heterocyclic ring in the benzil-d0/d5 labeled GCs and UCs improved the retention behaviors in liquid chromatography (LC) and increased the sensitivity of electrospray ionization mass spectrometry (ESI MS) detection. The fragment ion pairs of m/z 182/187 and m/z 210/215 from the benzil-d0/d5 tags facilitated the discovery of potential GCs and UCs candidates residing in biological matrices. The use of BRSIL combined with LC-ESI MS was applied for simultaneously quantitation of GCs and UCs in thyroid tissues. It was demonstrated that nine GCs and UCs were detected, six of which were further quantified based on corresponding standards. It was concluded that five GCs and UCs (l-arginine, homoarginine, 4-guanidinobutyric acid, methylguanidine, and citrulline) were statistically significantly different (p < 0.05) between the para-carcinoma and carcinoma thyroid tissue samples.
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Affiliation(s)
- Ruo-Jing Fan
- State Key Laboratory of Organmetallic Chemistry and National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai, 200032, People's Republic of China
| | - Qing Guan
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Fang Zhang
- State Key Laboratory of Organmetallic Chemistry and National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai, 200032, People's Republic of China.
| | - Jia-Peng Leng
- State Key Laboratory of Organmetallic Chemistry and National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai, 200032, People's Republic of China
| | - Tuan-Qi Sun
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Yin-Long Guo
- State Key Laboratory of Organmetallic Chemistry and National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai, 200032, People's Republic of China.
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Joncquel-Chevalier Curt M, Voicu PM, Fontaine M, Dessein AF, Porchet N, Mention-Mulliez K, Dobbelaere D, Soto-Ares G, Cheillan D, Vamecq J. Creatine biosynthesis and transport in health and disease. Biochimie 2015; 119:146-65. [DOI: 10.1016/j.biochi.2015.10.022] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/27/2015] [Indexed: 12/31/2022]
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Tran C, Yazdanpanah M, Kyriakopoulou L, Levandovskiy V, Zahid H, Naufer A, Isbrandt D, Schulze A. Stable isotope dilution microquantification of creatine metabolites in plasma, whole blood and dried blood spots for pharmacological studies in mouse models of creatine deficiency. Clin Chim Acta 2014; 436:160-8. [DOI: 10.1016/j.cca.2014.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 05/04/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
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Haas D, Gan-Schreier H, Langhans CD, Anninos A, Haege G, Burgard P, Schulze A, Hoffmann GF, Okun JG. Diagnosis and therapeutic monitoring of inborn errors of creatine metabolism and transport using liquid chromatography–tandem mass spectrometry in urine, plasma and CSF. Gene 2014; 538:188-94. [DOI: 10.1016/j.gene.2014.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 12/18/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
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Joncquel-Chevalier Curt M, Cheillan D, Briand G, Salomons GS, Mention-Mulliez K, Dobbelaere D, Cuisset JM, Lion-François L, Des Portes V, Chabli A, Valayannopoulos V, Benoist JF, Pinard JM, Simard G, Douay O, Deiva K, Tardieu M, Afenjar A, Héron D, Rivier F, Chabrol B, Prieur F, Cartault F, Pitelet G, Goldenberg A, Bekri S, Gerard M, Delorme R, Porchet N, Vianey-Saban C, Vamecq J. Creatine and guanidinoacetate reference values in a French population. Mol Genet Metab 2013; 110:263-7. [PMID: 24090707 DOI: 10.1016/j.ymgme.2013.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/07/2013] [Accepted: 09/07/2013] [Indexed: 01/19/2023]
Abstract
Creatine and guanidinoacetate are biomarkers of creatine metabolism. Their assays in body fluids may be used for detecting patients with primary creatine deficiency disorders (PCDD), a class of inherited diseases. Their laboratory values in blood and urine may vary with age, requiring that reference normal values are given within the age range. Despite the long known role of creatine for muscle physiology, muscle signs are not necessarily the major complaint expressed by PCDD patients. These disorders drastically affect brain function inducing, in patients, intellectual disability, autistic behavior and other neurological signs (delays in speech and language, epilepsy, ataxia, dystonia and choreoathetosis), being a common feature the drop in brain creatine content. For this reason, screening of PCDD patients has been repeatedly carried out in populations with neurological signs. This report is aimed at providing reference laboratory values and related age ranges found for a large scale population of patients with neurological signs (more than 6 thousand patients) previously serving as a background population for screening French patients with PCDD. These reference laboratory values and age ranges compare rather favorably with literature values for healthy populations. Some differences are also observed, and female participants are discriminated from male participants as regards to urine but not blood values including creatine on creatinine ratio and guanidinoacetate on creatinine ratio values. Such gender differences were previously observed in healthy populations; they might be explained by literature differential effects of testosterone and estrogen in adolescents and adults, and by estrogen effects in prepubertal age on SLC6A8 function. Finally, though they were acquired on a population with neurological signs, the present data might reasonably serve as reference laboratory values in any future medical study exploring abnormalities of creatine metabolism and transport.
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Affiliation(s)
- Marie Joncquel-Chevalier Curt
- Département de Biochimie et Biologie Moléculaire, Laboratoire d'Hormonologie, Metabolisme-Nutrition & Oncologie (HMNO) - Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand, CHRU Lille, 59037 Lille, France
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17
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Nouioua S, Cheillan D, Zaouidi S, Salomons G, Amedjout N, Kessaci F, Boulahdour N, Hamadouche T, Tazir M. Creatine deficiency syndrome. A treatable myopathy due to arginine–glycine amidinotransferase (AGAT) deficiency. Neuromuscul Disord 2013; 23:670-4. [DOI: 10.1016/j.nmd.2013.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 04/29/2013] [Indexed: 10/26/2022]
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18
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Imbard A, Blom HJ, Schlemmer D, Barto R, Czerkiewicz I, Rigal O, Muller F, Benoist JF. Methylation metabolites in amniotic fluid depend on gestational age. Prenat Diagn 2013; 33:848-55. [PMID: 23613283 DOI: 10.1002/pd.4142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Methylation metabolism is essential for fetus development. However, normative data for amniotic fluid (AF) concentrations of methylation metabolites at different gestational ages are lacking. We aimed to determine in AF reference values of 14 intermediates involved in methylation. METHODS Two hundred sixty-eight AFs sampled between 14 and 39 weeks of gestation were retrospectively selected in our AF bank. Next, we measured methionine (Met)-cycle intermediates [S-adenosyl Met (AdoMet), S-adenosyl-l-homocysteine (AdoHcy), total Hcy, Met, and methyl malonic acid] and methyl donors and methyl acceptors (betaine, dimethylglycine, sarcosine, free and total choline, free and total ethanolamine, creatine, and guanidinoacetate) by liquid chromatography coupled with tandem mass spectrometry. RESULTS Reference ranges according to gestational age were determined for each parameter. Strong correlations between metabolites directly connected in their metabolic pathway and between total Hcy and betaine were observed. CONCLUSION Methionine, an essential amino acid required for protein synthesis, is the only parameter that dramatically decreases with gestational age. The AdoMet/AdoHcy ratio exponentially increases from 25 weeks of gestation, which could reflect increasing methylation capacities. The negative correlation between betaine and total Hcy together with a constant betaine to dimethylglycine ratio during gestation suggests that betaine may be used as a methyl donor during fetal life.
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Affiliation(s)
- Apolline Imbard
- Biochemistry Hormonology Laboratory, AP-HP Hôpital Robert Debré, Paris, France.
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Cheillan D, Curt MJC, Briand G, Salomons GS, Mention-Mulliez K, Dobbelaere D, Cuisset JM, Lion-François L, Portes VD, Chabli A, Valayannopoulos V, Benoist JF, Pinard JM, Simard G, Douay O, Deiva K, Afenjar A, Héron D, Rivier F, Chabrol B, Prieur F, Cartault F, Pitelet G, Goldenberg A, Bekri S, Gerard M, Delorme R, Tardieu M, Porchet N, Vianey-Saban C, Vamecq J. Screening for primary creatine deficiencies in French patients with unexplained neurological symptoms. Orphanet J Rare Dis 2012; 7:96. [PMID: 23234264 PMCID: PMC3552865 DOI: 10.1186/1750-1172-7-96] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 12/07/2012] [Indexed: 12/11/2022] Open
Abstract
A population of patients with unexplained neurological symptoms from six major French university hospitals was screened over a 28-month period for primary creatine disorder (PCD). Urine guanidinoacetate (GAA) and creatine:creatinine ratios were measured in a cohort of 6,353 subjects to identify PCD patients and compile their clinical, 1H-MRS, biochemical and molecular data. Six GAMT [N-guanidinoacetatemethyltransferase (EC 2.1.1.2)] and 10 X-linked creatine transporter (SLC6A8) but no AGAT (GATM) [L-arginine/glycine amidinotransferase (EC 2.1.4.1)] deficient patients were identified in this manner. Three additional affected sibs were further identified after familial inquiry (1 brother with GAMT deficiency and 2 brothers with SLC6A8 deficiency in two different families). The prevalence of PCD in this population was 0.25% (0.09% and 0.16% for GAMT and SLC6A8 deficiencies, respectively). Seven new PCD-causing mutations were discovered (2 nonsense [c.577C > T and c.289C > T] and 1 splicing [c.391 + 15G > T] mutations for the GAMT gene and, 2 missense [c.1208C > A and c.926C > A], 1 frameshift [c.930delG] and 1 splicing [c.1393-1G > A] mutations for the SLC6A8 gene). No hot spot mutations were observed in these genes, as all the mutations were distributed throughout the entire gene sequences and were essentially patient/family specific. Approximately one fifth of the mutations of SLC6A8, but not GAMT, were attributed to neo-mutation, germinal or somatic mosaicism events. The only SLC6A8-deficient female patient in our series presented with the severe phenotype usually characterizing affected male patients, an observation in agreement with recent evidence that is in support of the fact that this X-linked disorder might be more frequent than expected in the female population with intellectual disability.
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Affiliation(s)
- David Cheillan
- Hospices Civils de Lyon, Service Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Groupement Hospitalier Est, Bron, 69677, France
| | - Marie Joncquel-Chevalier Curt
- Département de Biochimie et Biologie Moléculaire, Laboratoire d’Hormonologie, Métabolisme-Nutrition & Oncologie (HMNO)–Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand, CHRU Lille, Lille, 59037, France
| | - Gilbert Briand
- Département de Biochimie et Biologie Moléculaire, Laboratoire d’Hormonologie, Métabolisme-Nutrition & Oncologie (HMNO)–Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand, CHRU Lille, Lille, 59037, France
- Mass Spectrometry Application Laboratory, University of Lille 2, Lille, 59045, France
| | - Gajja S Salomons
- Metabolic Unit, Department of Clinical Chemistry, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Karine Mention-Mulliez
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Jeanne de Flandres, CHRU Lille, Lille, 59037, France
| | - Dries Dobbelaere
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Jeanne de Flandres, CHRU Lille, Lille, 59037, France
| | - Jean-Marie Cuisset
- Service de Neurologie Infantile, Hôpital Roger Salengro, CHRU Lille, Lille, 59037, France
| | - Laurence Lion-François
- Service de neurologie pédiatrique, CHU de Lyon-GH Est - Hôpital Femme Mère Enfant, Bron Cedex, 69677, France
| | - Vincent Des Portes
- Service de neurologie pédiatrique, CHU de Lyon-GH Est - Hôpital Femme Mère Enfant, Bron Cedex, 69677, France
| | - Allel Chabli
- Laboratory of Biochemistry, Necker – Enfants Malades Hospital and Université Paris Descartes, Paris, 75015, France
| | - Vassili Valayannopoulos
- Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Necker des Enfants Malades and Université Paris Descartes, 149 rue de Sèvres, Paris, 75015, France
| | - Jean-François Benoist
- Département de Biochimie-Hormonologie, CHU Hôpital Robert Debré, Paris, 75019, France
| | - Jean-Marc Pinard
- Unité de Neurologie Pédiatrique, Département de Pédiatrie, Hôpital Raymond Poincare, Paris-IdF-Ouest University, Paris, France
| | - Gilles Simard
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Angers, Angers, 49033, France
| | - Olivier Douay
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Angers, Angers, 49033, France
| | - Kumaran Deiva
- Service de Neuropédiatrie - CHU de Bicêtre, Le Kremlin Bicêtre Cedex, 94275, France
| | - Alexandra Afenjar
- Service de Neuropédiatrie, Hôpital Armand Trousseau, Groupement hospitalier universitaire Est, Paris, 75012, France
| | - Delphine Héron
- Unité Fonctionnelle de Génétique Médicale AP-HP, Département de Génétique et Cytogénétique, Centre de Référence «Déficiences intellectuelles de causes rares », CRicm, UMR-S975, Groupe Hospitalier Pitié-Salpêtrière, Paris, F-75013, France
| | - François Rivier
- Neuropédiatrie, CHRU Montpellier, & Inserm U1046, Université Montpellier 1 & 2, Montpellier Cedex 5, 34295, France
| | - Brigitte Chabrol
- Service Neuropédiatrie, AP-HM Hôpital de la Timone, Marseille Cedex 5, 13385, France
| | - Fabienne Prieur
- Service de Génétique, CHU de Saint-Étienne Hôpital Nord, Saint-Etienne Cédex 2, 42055, France
| | - François Cartault
- Service de génétique Centre hospitalier Felix Guyon (Saint-Denis) Bellepierre, Saint-Denis cedex, 97405, France
| | - Gaëlle Pitelet
- Service de Neuropédiatrie, Hôpital de l’Archet 2, Nice Cedex 3, 06202, France
| | - Alice Goldenberg
- Service de Génétique Médicale, CHU Ch. Nicolle, Rouen Cedex, 76031, France
| | - Soumeya Bekri
- Institut de Biologie Clinique, CHU Ch. Nicolle, Rouen Cedex, 76031, France
| | - Marion Gerard
- Service de Génétique, CHU Clémenceau, Caen, 14033, France
| | - Richard Delorme
- Service de Pédopsychiatrie CHU Hôpital Robert Debré, Paris, 75019, France
| | - Marc Tardieu
- Service de Neuropédiatrie - CHU de Bicêtre, Le Kremlin Bicêtre Cedex, 94275, France
| | - Nicole Porchet
- Département de Biochimie et Biologie Moléculaire, Laboratoire d’Hormonologie, Métabolisme-Nutrition & Oncologie (HMNO)–Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand, CHRU Lille, Lille, 59037, France
| | - Christine Vianey-Saban
- Hospices Civils de Lyon, Service Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Groupement Hospitalier Est, Bron, 69677, France
| | - Joseph Vamecq
- Département de Biochimie et Biologie Moléculaire, Laboratoire d’Hormonologie, Métabolisme-Nutrition & Oncologie (HMNO)–Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand, CHRU Lille, Lille, 59037, France
- Inserm, Laboratoire Externe, Département du Prof. Nicole Porchet, HMNO, Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand, CHRU Lille, Lille, 59037, France
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Gas Chromatographic Determination of Guanidino Compounds Using Hexafluoroacetylacetone and Ethyl Chloroformate as Derivatizing Reagents. Chromatographia 2012. [DOI: 10.1007/s10337-012-2363-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Boenzi S, Rizzo C, Di Ciommo VM, Martinelli D, Goffredo BM, la Marca G, Dionisi-Vici C. Simultaneous determination of creatine and guanidinoacetate in plasma by liquid chromatography–tandem mass spectrometry (LC–MS/MS). J Pharm Biomed Anal 2011; 56:792-8. [DOI: 10.1016/j.jpba.2011.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 05/31/2011] [Accepted: 06/09/2011] [Indexed: 11/28/2022]
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Wada T, Shimbo H, Osaka H. A simple screening method using ion chromatography for the diagnosis of cerebral creatine deficiency syndromes. Amino Acids 2011; 43:993-7. [PMID: 22080216 DOI: 10.1007/s00726-011-1146-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 11/01/2011] [Indexed: 11/24/2022]
Abstract
Cerebral creatine deficiency syndromes (CCDS) are caused by genetic defects in L-arginine:glycine amidinotransferase, guanidinoacetate methyltransferase or creatine transporter 1. CCDS are characterized by abnormal concentrations of urinary creatine (CR), guanidinoacetic acid (GA), or creatinine (CN). In this study, we describe a simple HPLC method to determine the concentrations of CR, GA, and CN using a weak-acid ion chromatography column with a UV detector without any derivatization. CR, GA, and CN were separated clearly with the retention times (mean ± SD, n = 3) of 5.54 ± 0.0035 min for CR, 6.41 ± 0.0079 min for GA, and 13.53 ± 0.046 min for CN. This new method should provide a simple screening test for the diagnosis of CCDS.
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Affiliation(s)
- Takahito Wada
- Division of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan
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Nasrallah F, Feki M, Briand G, Kaabachi N. GC/MS determination of guanidinoacetate and creatine in urine: A routine method for creatine deficiency syndrome diagnosis. Clin Biochem 2010; 43:1356-61. [DOI: 10.1016/j.clinbiochem.2010.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 07/29/2010] [Accepted: 08/05/2010] [Indexed: 11/16/2022]
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Nasrallah F, Feki M, Kaabachi N. Creatine and creatine deficiency syndromes: biochemical and clinical aspects. Pediatr Neurol 2010; 42:163-71. [PMID: 20159424 DOI: 10.1016/j.pediatrneurol.2009.07.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Revised: 06/10/2009] [Accepted: 07/30/2009] [Indexed: 11/28/2022]
Abstract
Creatine deficiency syndromes, which have only recently been described, represent a group of inborn errors of creatine synthesis (L-arginine-glycine amidinotransferase deficiency and guanidinoacetate methyltransferase deficiency) and transport (creatine transporter deficiency). Patients with creatine deficiency syndromes present with mental retardation expressive speech and language delay, and epilepsy. Patients with guanidinoacetate methyltransferase deficiency or creatine transporter deficiency may exhibit autistic behavior. The common denominator of these disorders is the depletion of the brain creatine pool, as demonstrated by in vivo proton magnetic resonance spectroscopy. For diagnosis, laboratory investigations start with analysis of guanidinoacetate, creatine, and creatinine in plasma and urine. Based on these findings, enzyme assays or DNA mutation analysis may be performed. The creatine deficiency syndromes are underdiagnosed, so the possibility should be considered in all children affected by unexplained mental retardation, seizures, and speech delay. Guanidinoacetate methyltransferase deficiency and arginine-glycine amidinotransferase deficiency are treatable by oral creatine supplementation, but patients with creatine transporter deficiency do not respond to this type of treatment.
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Xia JF, Liang QL, Liang XP, Wang YM, Hu P, Li P, Luo GA. Ultraviolet and tandem mass spectrometry for simultaneous quantification of 21 pivotal metabolites in plasma from patients with diabetic nephropathy. J Chromatogr B Analyt Technol Biomed Life Sci 2009; 877:1930-6. [DOI: 10.1016/j.jchromb.2009.05.047] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 05/14/2009] [Accepted: 05/20/2009] [Indexed: 11/26/2022]
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Prieto JA, Andrade F, Martín S, Sanjurjo P, Elorz J, Aldámiz-Echevarría L. Determination of creatine and guanidinoacetate by GC-MS. Clin Biochem 2009; 42:125-8. [DOI: 10.1016/j.clinbiochem.2008.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Revised: 10/01/2008] [Accepted: 10/02/2008] [Indexed: 11/25/2022]
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Carling RS, Hogg SL, Wood TC, Calvin J. Simultaneous determination of guanidinoacetate, creatine and creatinine in urine and plasma by un-derivatized liquid chromatography-tandem mass spectrometry. Ann Clin Biochem 2008; 45:575-84. [DOI: 10.1258/acb.2008.008029] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Creatine plays an important role in the storage and transmission of phosphate-bound energy. The cerebral creatine deficiency syndromes (CCDS) comprise three inherited defects in creatine biosynthesis and transport. They are characterized by mental retardation, speech and language delay and epilepsy. All three disorders cause low-creatine signal on brain magnetic resonance spectroscopy (MRS); however, MRS may not be readily available and even when it is, biochemical tests are required to determine the underlying disorder. Methods Analysis was performed by liquid chromatography-tandem mass spectrometry in positive ionization mode. Samples were analysed underivatized using a rapid ‘dilute and shoot’ approach. Chromatographic separation of the three compounds was achieved. Stable isotope internal standards were used for quantification. Results Creatine, creatinine and guanidinoacetate were measured with a 2.5 minute run time. For guanidinoacetate, the standard curve was linear to at least 5000 μmol/L and for creatine and creatinine it was linear to at least 25 mmol/L. The lower limit of quantitation was 0.4 μmol/L for creatine and guanidinoacetate and 0.8 μmol/L for creatinine. Recoveries ranged from 86% to 106% for the three analytes. Intra- and inter-assay variation for each analyte was <10% in both urine and plasma. Conclusion A tandem mass spectrometric method has been developed and validated for the underivatized determination of guanidinoacetate, creatine and creatinine in human urine and plasma. Minimal sample preparation coupled with a rapid run time make the method applicable to the routine screening of patients with suspected CCDS.
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Affiliation(s)
- R S Carling
- Biochemical Genetics Unit, Box 247, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - S L Hogg
- Biochemical Genetics Unit, Box 247, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - T C Wood
- Biochemical Genetics Laboratory, Greenwood Genetic Center, 125 Gregor Mendel Circle, Greenwood SC 29646, USA
| | - J Calvin
- Biochemical Genetics Unit, Box 247, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK
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Young S, Struys E, Wood T. Quantification of creatine and guanidinoacetate using GC-MS and LC-MS/MS for the detection of cerebral creatine deficiency syndromes. ACTA ACUST UNITED AC 2008; Chapter 17:Unit 17.3. [PMID: 18428409 DOI: 10.1002/0471142905.hg1703s54] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Inherited defects in creatine biosynthesis and cellular uptake are neurometabolic disorders characterized by seizures, developmental delay, mental retardation, autistic-like behavior, and creatine deficiency in the brain. Metabolic screening of these disorders is possible using analytical techniques that quantify creatine and its precursor guanidinoacetate in urine, plasma, or cerebrospinal fluid (CSF). Elevated creatine in urine is suggestive of a deficiency of the X-linked creatine transporter, SLC6A8. Decreased or elevated levels of guanidinoacetate in urine, plasma, or CSF suggest deficiencies of the creatine biosynthetic enzymes, arginine:glycine amidinotransferase (AGAT) or guanidinoacetate methyltransferase (GAMT), respectively. This unit describes three stable isotope dilution-mass spectrometric methods for analyzing creatine and guanidinoacetate. Gas chromatography/mass spectrometry with negative-ion chemical ionization is a highly sensitive technique, suitable for detection of low analyte levels resulting from AGAT deficiency and in CSF. The two liquid chromatography-tandem mass spectrometric approaches are amenable to high-throughput screening and have simple sample preparation requirements.
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Affiliation(s)
- Sarah Young
- Duke University Medical Center, Research Triangle Park, North Carolina, USA
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Almeida LS, Vilarinho L, Darmin PS, Rosenberg EH, Martinez-Muñoz C, Jakobs C, Salomons GS. A prevalent pathogenic GAMT mutation (c.59G>C) in Portugal. Mol Genet Metab 2007; 91:1-6. [PMID: 17336114 DOI: 10.1016/j.ymgme.2007.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Revised: 01/09/2007] [Accepted: 01/10/2007] [Indexed: 11/17/2022]
Abstract
Guanidinoacetate methyltransferase (GAMT) deficiency (MIM 601240), an autosomal recessive disorder of creatine biosynthesis, presents with mental retardation, extrapyramidal symptoms, autistic-like behavior and epilepsy. Other hallmarks are cerebral creatine deficiency, increased levels of guanidinoacetate in body fluids and mutations in the GAMT gene. Creatine supplementation partially restores cerebral creatine content. Worldwide, 29 patients have been identified and 15 different mutations have been reported in the GAMT gene. Ten out of these 29 patients are of Portuguese origin. Likely, a founder effect and a high carrier rate in Portugal exist, since in 17 out of the 20 Portuguese alleles the c.59G>C; p.Trp20Ser mutation was found. We investigated the carrier rate of the c.59G>C; p.Trp20Ser mutation in different regions of Portugal and confirmed the pathogenic nature of this missense mutation by transient transfections. Anonymous bloodspots (1002) were screened for the presence of the c.59G>C; p.Trp20Ser mutation by SNaPshot (Single Nucleotide Polymorphism Multiplex Kit). Eight carriers of c.59G>C; p.Trp20Ser were detected of which four are derived from the Archipelagos. This suggests that the carrier rate of the c.59G>C; p.Trp20Ser mutation is relatively high in these islands, as well as in other parts of Portugal. It also implies that newborn screening in these regions is warranted for this treatable disorder.
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Affiliation(s)
- L S Almeida
- Department of Clinical Chemistry, Metabolic Unit, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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Almeida LS, Rosenberg EH, Verhoeven NM, Jakobs C, Salomons GS. Are cerebral creatine deficiency syndromes on the radar screen? FUTURE NEUROLOGY 2006. [DOI: 10.2217/14796708.1.5.637] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cerebral creatine deficiency syndromes (CCDS) are responsible for a considerable proportion of the population affected with mental retardation. CCDS are caused by either an inborn error of the proteins involved in creatine biosynthesis or in the creatine transporter. Besides mental retardation, the clinical characteristics of CCDS are speech and language delay, epilepsy and features of autism. CCDS can be diagnosed by proton magnetic resonance spectroscopy of the brain and/or by biochemical and molecular analysis. Treatment of the defects in creatine biosynthesis has yielded favorable outcomes, while treatments for creatine transporter deficiency are still under investigation at this time. The relatively large contribution of the CCDS to the monogenic causes of mental retardation emphasizes the importance of including CCDS in the differential diagnosis of mental retardation of unknown etiology. Pathophysiology is not yet unravelled, although it is known that creatine plays an important role in energy storage and transmission. Moreover, in vitro data indicate that creatine acts as a neuromodulator in the brain.
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Affiliation(s)
- Lígia S Almeida
- VU University Medical Center, Department of Clinical Chemistry, Metabolic Unit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Efraim H Rosenberg
- VU University Medical Center, Department of Clinical Chemistry, Metabolic Unit, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Nanda M Verhoeven
- VU University Medical Center, Department of Clinical Chemistry, Metabolic Unit, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Cornelis Jakobs
- VU University Medical Center, Department of Clinical Chemistry, Metabolic Unit, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Gajja S Salomons
- VU University Medical Center, Department of Clinical Chemistry, Metabolic Unit, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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Arias A, Ormazabal A, Moreno J, González B, Vilaseca MA, García-Villoria J, Pàmpols T, Briones P, Artuch R, Ribes A. Methods for the diagnosis of creatine deficiency syndromes: A comparative study. J Neurosci Methods 2006; 156:305-9. [PMID: 16621013 DOI: 10.1016/j.jneumeth.2006.03.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Revised: 03/07/2006] [Accepted: 03/08/2006] [Indexed: 11/22/2022]
Abstract
The increasing number of patients with creatine deficiency syndromes (CDS) stresses the need to develop screening procedures for the identification these inherited disorders. Guanidinoacetate (GAA) and creatine (Cr) are reliable biochemical markers of CDS and several analytical methods to measure both metabolites have been developed. High-pressure liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) is quick and sensitive but, unlike HPLC and gas chromatography-mass spectrometry (GC/MS), it is unavailable in most laboratories. Thus, we decided to evaluate comparatively HPLC-MS/MS, GC/MS and HPLC methods, as well as to establish reference values in a healthy paediatric population. According to our results, these three methods may be suitable for analysing GAA in urine. Furthermore, Passing-Bablock plots showed good agreement among all three. However, when comparing the Cr/Crn ratio, our results revealed that while HPLC-MS/MS data were in agreement with those of GC/MS, a constant and proportional error was observed when compared with those of HPLC. Consequently, the Cr/Crn ratio obtained by the last method should be evaluated with caution. Our reference values for GAA and Cr/Crn ratio in urine negatively correlate with age. Concerning GAA and Cr measurements in plasma, it is interesting to note that in contrast to what was occurring in urine, GAA concentration increased significantly with age, while we did not find any significant difference for Cr values within the same age group.
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Affiliation(s)
- Angela Arias
- Servei de Bioquímica, Hospital Sant Joan de Déu, Esplugues, Barcelona, Spain
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Garg U, Dasouki M. Expanded newborn screening of inherited metabolic disorders by tandem mass spectrometry: Clinical and laboratory aspects. Clin Biochem 2006; 39:315-32. [PMID: 16563365 DOI: 10.1016/j.clinbiochem.2005.12.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2005] [Revised: 12/15/2005] [Accepted: 12/20/2005] [Indexed: 11/27/2022]
Abstract
Newborn screening started in the 1960s for the purpose of identifying phenylketonuric patients to begin early intervention and to prevent mental retardation in these patients. Soon thereafter, screening programs expanded to include additional genetic disorders added individually one at a time. In the 1980s, tandem mass spectrometry (MS/MS) was introduced in clinical laboratories, and in the 1990s, the technique was used for newborn screening. Unlike measuring one analyte at a time, MS/MS allows measurement of >40 analytes, in a few minutes with the use of a single assay. Currently, MS/MS is being used for the identification of several amino acid, organic acid and fatty acid disorders. Several states in the United States and many other countries are using MS/MS in newborn screening. However, there is a significant disparity among different newborn screening programs for disorders being screened by MS/MS and many other challenges are faced by the expanded newborn screening. It is anticipated that in the future the use of MS/MS in newborn screening will expand both at the analyte and geographic levels. Clinicians and laboratory scientists should become familiar with MS/MS, disorders being screened in their patients' population and the future of this emerging technology.
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Affiliation(s)
- Uttam Garg
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA.
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Cheillan D, Salomons GS, Acquaviva C, Boisson C, Roth P, Cordier MP, François L, Jakobs C, Vianey-Saban C. Prenatal Diagnosis of Guanidinoacetate Methyltransferase Deficiency: Increased Guanidinoacetate Concentrations in Amniotic Fluid. Clin Chem 2006; 52:775-7. [PMID: 16595836 DOI: 10.1373/clinchem.2005.065185] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Carducci C, Santagata S, Leuzzi V, Carducci C, Artiola C, Giovanniello T, Battini R, Antonozzi I. Quantitative determination of guanidinoacetate and creatine in dried blood spot by flow injection analysis-electrospray tandem mass spectrometry. Clin Chim Acta 2006; 364:180-7. [PMID: 16197934 DOI: 10.1016/j.cca.2005.06.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 06/16/2005] [Accepted: 06/17/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Guanidinoacetate (GAA) and creatine (Cr) are reliable biochemical markers of primary creatine disorders. The aim of this study was to develop and validate a method for the determination of GAA and Cr in dried blood spot through the use of stable isotope dilution and flow injection analysis (FIA)-ESI-MS/MS. METHODS Dried blood spots were extracted using methanol-water solution containing D3-Cr. After evaporation and formation of butyl esters, samples were analyzed using multiple reaction monitoring mode (m/z 174.2-->101.1 for GAA, 188.3-->90.1 for Cr and 191.3-->93.1 for D3-Cr). RESULTS The analysis was very fast (1 min). The detection limits were 0.34 micromol/l of blood and 0.30 micromol/l of blood for Cr and GAA, respectively, and the response was linear over the range 0.25-12.5 micromol/l of blood for GAA and 3.57-624.7 micromol/l of blood for Cr. Recovery range was 93-101% for Cr and 94-105% for GAA and between-run CVs were 5.3% for GAA and 4.5% for Cr. Ion suppression effect was also studied. The method was applied to spots obtained from two patients affected by GAMT deficiency, four patients affected by AGAT deficiency (including a newborn) as well as 282 healthy subjects. CONCLUSIONS The detection of GAA in dried blood spot by FIA-ESI-MS/MS is a highly reliable and high throughput method for the diagnosis of GAMT and AGAT deficiencies and a possible tool for newborn screening of both these tractable disorders.
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Affiliation(s)
- Claudia Carducci
- Dipartimento di Medicina Sperimentale e Patologia, Università di Roma La Sapienza, Viale del Policlinico 155, 00161 Roma, Italy.
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Verhoeven NM, Salomons GS, Jakobs C. Laboratory diagnosis of defects of creatine biosynthesis and transport. Clin Chim Acta 2005; 361:1-9. [PMID: 16169544 DOI: 10.1016/j.cccn.2005.04.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Revised: 04/05/2005] [Accepted: 04/12/2005] [Indexed: 10/25/2022]
Abstract
In recent years, three inherited defects in the biosynthesis and transport of creatine have been described. The biosynthetic defects include deficiencies of L-arginine:glycine amidinotransferase and guanidinoacetate methyltransferase. The third defect is a functional defect in the creatine transporter (SLC6A8). Clinical symptoms of the three defects vary in severity, are aspecific and include mental retardation with severe speech delay, autistiform behaviour, and epilepsy. Some patients with GAMT deficiency exhibit a more complex clinical phenotype with extrapyramidal movement disorder. All three defects can be diagnosed by in vivo proton magnetic resonance spectroscopy of the brain, which shows a severe reduction or absence of creatine. Laboratory investigations for the diagnosis start with the analysis of guanidinoacetate, creatine and creatinine in body fluids (plasma and urine). Based on these findings, enzyme assays for AGAT or GAMT, or a creatine uptake assay for the transporter defect can be performed. DNA mutation analysis of the genes involved can prove the defects at the molecular level. To diagnose female patients with SLC6A8 deficiency, mutation analysis may be the only choice.
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Affiliation(s)
- Nanda M Verhoeven
- Metabolic Unit, Department of Clinical Chemistry, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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Abstract
Mental retardation is more common in males than females in the population, assumed to be due to mutations on the X chromosome. The prevalence of the 24 genes identified to date is low and less common than expansions in FMR1, which cause Fragile X syndrome. Systematic screening of all other X linked genes in X linked families with mental retardation is currently not feasible in a clinical setting. The phenotypes of genes causing syndromic and non-syndromic mental retardation (NLGN3, NLGN4, RPS6KA3(RSK2), OPHN1, ATRX, SLC6A8, ARX, SYN1, AGTR2, MECP2, PQBP1, SMCX, and SLC16A2) are first discussed, as these may be the focus of more targeted mutation analysis. Secondly, the relative prevalence of genes causing only non-syndromic mental retardation (IL1RAPL1, TM4SF2, ZNF41, FTSJ1, DLG3, FACL4, PAK3, ARHGEF6, FMR2, and GDI) is summarised. Thirdly, the problem of recurrence risk where a molecular genetics diagnosis has not been made and what proportion of the male excess of mental retardation is due to monogenic disorders of the X chromosome are discussed.
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Affiliation(s)
- F L Raymond
- Cambridge Institute of Medical Research, Department of Medical Genetics, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 2XY, UK.
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Cheillan D, Cognat S, Vandenberghe N, Des Portes V, Vianey-Saban C. Les syndromes de déficit en créatine. Rev Neurol (Paris) 2005; 161:284-9. [PMID: 15800449 DOI: 10.1016/s0035-3787(05)85034-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Creatine deficiency syndromes are a newly described group of inborn errors of metabolism affecting creatine metabolism. Three diseases have been described: deficiency of arginine: glycine amidinotransferase (AGAT), deficiency of guanidinoacetate methyltransferase (GAMT) and creatine transporter defect (CRTR). STATE OF ART These syndromes are characterized by a depletion of creatine/phosphocreatine in the brain. Clinically, most of the patients develop a variable mental retardation and a severe speech delay associated with epilepsy, extra-pyramidal syndrome and behavior disturbances. These diseases are often diagnosed during infancy but a few adult cases have been reported recently. Diagnosis is established by measurement of guanidinoacetate and creatine in biologic fluids and in vivo proton magnetic resonance spectroscopy by the total lack of intra-cerebral creatine/phosphocreatine demonstrating. GAMT and AGAT deficiencies are treatable by oral creatine supplementation whereas patients with CRTR do not respond to the treatment. CONCLUSION Better knowledge of these syndromes is necessary to optimize diagnosis and patient management of these rare but potentially treatable disorders.
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Affiliation(s)
- D Cheillan
- Service de Biochimie Pédiatrique, Hôpital Debrousse, 29, rue Soeur-Bouvier, 69322 Lyon, France.
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Current literature in mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2005; 40:129-140. [PMID: 15672451 DOI: 10.1002/jms.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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