1
|
Chandler RJ, Venditti CP. Gene therapy for organic acidemias: Lessons learned from methylmalonic and propionic acidemia. J Inherit Metab Dis 2024; 47:63-79. [PMID: 37530705 DOI: 10.1002/jimd.12665] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/03/2023]
Abstract
Organic acidemias (OA) are a group of rare autosomal recessive disorders of intermediary metabolism that result in a systemic elevation of organic acid. Despite optimal dietary and cofactor therapy, OA patients still suffer from potentially lethal metabolic instability and experience long-term multisystemic complications. Severely affected patients can benefit from elective liver transplantation, which restores hepatic enzymatic activity, improves metabolic stability, and provides the theoretical basis for the pursuit of gene therapy as a new treatment for patients. Because of the poor outcomes reported in those with OA, especially methylmalonic and propionic acidemia, multiple gene therapy approaches have been explored in relevant animal models. Here, we review the results of gene therapy experiments performed using MMA and PA mouse models to illustrate experimental paradigms that could be applicable for all forms of OA.
Collapse
Affiliation(s)
- Randy J Chandler
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Charles P Venditti
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
2
|
Cui H, Srinivasan S, Gao Z, Korkin D. The Extent of Edgetic Perturbations in the Human Interactome Caused by Population-Specific Mutations. Biomolecules 2023; 14:40. [PMID: 38254640 PMCID: PMC11154503 DOI: 10.3390/biom14010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/24/2024] Open
Abstract
Until recently, efforts in population genetics have been focused primarily on people of European ancestry. To attenuate this bias, global population studies, such as the 1000 Genomes Project, have revealed differences in genetic variation across ethnic groups. How many of these differences can be attributed to population-specific traits? To answer this question, the mutation data must be linked with functional outcomes. A new "edgotype" concept has been proposed, which emphasizes the interaction-specific, "edgetic", perturbations caused by mutations in the interacting proteins. In this work, we performed systematic in silico edgetic profiling of ~50,000 non-synonymous SNVs (nsSNVs) from the 1000 Genomes Project by leveraging our semi-supervised learning approach SNP-IN tool on a comprehensive set of over 10,000 protein interaction complexes. We interrogated the functional roles of the variants and their impact on the human interactome and compared the results with the pathogenic variants disrupting PPIs in the same interactome. Our results demonstrated that a considerable number of nsSNVs from healthy populations could rewire the interactome. We also showed that the proteins enriched with interaction-disrupting mutations were associated with diverse functions and had implications in a broad spectrum of diseases. Further analysis indicated that distinct gene edgetic profiles among major populations could shed light on the molecular mechanisms behind the population phenotypic variances. Finally, the network analysis revealed that the disease-associated modules surprisingly harbored a higher density of interaction-disrupting mutations from healthy populations. The variation in the cumulative network damage within these modules could potentially account for the observed disparities in disease susceptibility, which are distinctly specific to certain populations. Our work demonstrates the feasibility of a large-scale in silico edgetic study, and reveals insights into the orchestrated play of population-specific mutations in the human interactome.
Collapse
Affiliation(s)
- Hongzhu Cui
- Bioinformatics and Computational Biology Program, Worcester Polytechnic Institute, Worcester, MA 01609, USA;
- Chromatography and Mass Spectrometry Division, Thermo Fisher Scientific, San Jose, CA 95134, USA
| | - Suhas Srinivasan
- Data Science Program, Worcester Polytechnic Institute, Worcester, MA 01609, USA;
- Program in Epithelial Biology, Stanford School of Medicine, Stanford, CA 94305, USA
- Center for Personal Dynamic Regulomes, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Ziyang Gao
- Bioinformatics and Computational Biology Program, Worcester Polytechnic Institute, Worcester, MA 01609, USA;
| | - Dmitry Korkin
- Bioinformatics and Computational Biology Program, Worcester Polytechnic Institute, Worcester, MA 01609, USA;
- Data Science Program, Worcester Polytechnic Institute, Worcester, MA 01609, USA;
- Computer Science Department, Worcester Polytechnic Institute, Worcester, MA 01609, USA
| |
Collapse
|
3
|
Zhou C, Li J, Guo C, Zhou Z, Yang Z, Zhang Y, Jiang J, Cai Y, Zhou J, Xia M, Ming Y. Alterations in gut microbiome and metabolite profile of patients with Schistosoma japonicum infection. Parasit Vectors 2023; 16:346. [PMID: 37798771 PMCID: PMC10552355 DOI: 10.1186/s13071-023-05970-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Schistosoma infection is a significant public health issue, affecting over 200 million individuals and threatening 700 million people worldwide. The species prevalent in China is Schistosoma japonicum. Recent studies showed that both gut microbiota and metabolome are closely related to schistosomiasis caused by S. japonicum, but clinical study is limited and the underlying mechanism is largely unclear. This study aimed to explore alterations as well as function of gut microbiota and metabolite profile in the patients with S. japonicum infection. METHODS This study included 20 patients diagnosed with chronic schistosomiasis caused by S. japonicum, eight patients with advanced schistosomiasis caused by S. japonicum and 13 healthy volunteers. The fresh feces of these participators, clinical examination results and basic information were collected. 16S ribosomal RNA gene sequencing was used to investigate gut microbiota, while ultraperformance liquid chromatography-mass spectrometry (UHPLC-MS) was applied to explore the metabolome of patients in different stages of schistosomiasis. RESULTS The study found that gut microbiota and metabolites were altered in patients with different stages of S. japonicum infection. Compared with healthy control group, the gut microbial diversity in patients with chronic S. japonicum infection was decreased significantly. However, the diversity of gut microbiota in patients with chronic schistosomiasis was similar to that in patients with advanced schistosomiasis. Compared with uninfected people, patients with schistosomiasis showed decreased Firmicutes and increased Proteobacteria. As disease progressed, Firmicutes was further reduced in patients with advanced S. japonicum infection, while Proteobacteria was further increased. In addition, the most altered metabolites in patients with S. japonicum infection were lipids and lipid-like molecules as well as organo-heterocyclic compounds, correlated with the clinical manifestations and disease progress of schistosomiasis caused by S. japonicum. CONCLUSIONS This study suggested that the gut microbiota and metabolome altered in patients in different stages of schistosomiasis, which was correlated with progression of schistosomiasis caused by S. japonicum. This inter-omics analysis may shed light on a better understanding of the mechanisms of the progression of S. japonicum infection and contribute to identifying new potential targets for the diagnosis and prognosis of S. japonicum infection. However, a large sample size of validation in clinic is needed, and further study is required to investigate the underlying mechanism.
Collapse
Affiliation(s)
- Chen Zhou
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Junhui Li
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chen Guo
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhaoqin Zhou
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhen Yang
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu Zhang
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Jiang
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu Cai
- Schistosomiasis Control Institute of Hunan Province, Yueyang, Hunan, China
| | - Jie Zhou
- Schistosomiasis Control Institute of Hunan Province, Yueyang, Hunan, China
| | - Meng Xia
- Schistosomiasis Control Institute of Hunan Province, Yueyang, Hunan, China
| | - Yingzi Ming
- Transplantation Center, Engineering and Technology Research Center for Transplantation Medicine of National Health Commission, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| |
Collapse
|
4
|
An automated workflow on data processing (AutoDP) for semiquantitative analysis of urine organic acids with GC-MS to facilitate diagnosis of inborn errors of metabolism. Clin Chim Acta 2023; 540:117230. [PMID: 36682441 DOI: 10.1016/j.cca.2023.117230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 12/29/2022] [Accepted: 01/13/2023] [Indexed: 01/22/2023]
Abstract
Determination of urine organic acids (UOAs) is essential to understand the disease progress of inborn errors of metabolism (IEM) and often relies on GC-MS analysis. However, the efficiency of analytical reports is sometimes restricted by data processing due to labor-intensive work if no proper tool is employed. Herein, we present a simple and rapid workflow with an R-based script for automated data processing (AutoDP) of GC-MS raw files to quantitatively analyze essential UOAs. AutoDP features automatic quality checks, compound identification and confirmation with specific fragment ions, retention time correction from analytical batches, and visualization of abnormal UOAs with age-matched references on chromatograms. Compared with manual processing, AutoDP greatly reduces analytical time and increases the number of identifications. Speeding up data processing is expected to shorten the waiting time for clinical diagnosis, which could greatly benefit clinicians and patients with IEM. In addition, with quantitative results obtained from AutoDP, it would be more feasible to perform retrospective analysis of specific UOAs in IEM and could provide new perspectives for studying IEM.
Collapse
|
5
|
Li X, He J, He L, Zeng Y, Huang X, Luo Y, Li Y. Spectrum Analysis of Inherited Metabolic Disorders for Expanded Newborn Screening in a Central Chinese Population. Front Genet 2022; 12:763222. [PMID: 35095998 PMCID: PMC8790479 DOI: 10.3389/fgene.2021.763222] [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: 08/23/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Neonatal inherited metabolic disorders (IMDs) are closely associated with early neonatal death and abnormal growth and development. Increasing attention has been paid to IMDs because of their high incidence and diversity. However, there are no reports about the incidence of IMDs in Changsha, China. Therefore, we retrospectively analyzed the screening results of neonates to evaluate the characteristics of IMDs in the area. From January 2016 to December 2020, 300,849 neonates were enrolled for expanded newborn screening by tandem mass spectrometry in the Neonatal Disease Screening Center of the Changsha Hospital for Maternal & Child Health Care. Newborns with mild initial results were recalled for repeated tests; if the second test was still positive, the patient was referred for confirmatory tests. A total of 71 confirmed cases were identified in our study, with an incidence rate of 1:4,237. There were 28 cases of amino acid metabolic disorders, representing 39.44% of the IMDs diagnosed, with an incidence rate of 1:10,745. Twelve newborns were diagnosed with organic acid metabolic disorders, accounting for 16.66% of IMDs, with an incidence rate of 1:25,071. There were 31 cases of fatty acid oxidation disorders, representing 43.05% of IMDs, with an incidence rate of 1:9,705. Overall, 14 types of IMDs were found in Changsha. The most common disorders in the region were primary carnitine deficiency, hyperphenylalaninemia and short-chain acyl-CoA dehydrogenase deficiency. Their incidence rate is respectively 1:13,675, 1:16,714 and 1:42,978. The mutations in PAH, SLC22A5, and ACADS are the leading causes of IMDs in this area. This study demonstrates the importance of utilizing MS/MS in IMD screening for early diagnosis and treatment. This strategy may be used for prenatal genetic counseling to avoid irreversible growth and intellectual development disorders in children.
Collapse
Affiliation(s)
- Xia Li
- Neonatal Disease Screening Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China
| | - Jun He
- Neonatal Disease Screening Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China
| | - Ling He
- Neonatal Disease Screening Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China
| | - Yudong Zeng
- Neonatal Disease Screening Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China
| | - Xuzhen Huang
- Technical Support Center, Zhejiang Biosan Biochemical Technologies Co., Ltd, Hangzhou, China
| | - Yechao Luo
- Neonatal Disease Screening Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China
| | - Yujiao Li
- Neonatal Disease Screening Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China
| |
Collapse
|
6
|
Gomez-Gomez A, Olesti E, Montero-San-Martin B, Soldevila A, Deschamps T, Pizarro N, de la Torre R, Pozo OJ. Determination of up to twenty carboxylic acid containing compounds in clinically relevant matrices by o-benzylhydroxylamine derivatization and liquid chromatography-tandem mass spectrometry. J Pharm Biomed Anal 2022; 208:114450. [PMID: 34798391 DOI: 10.1016/j.jpba.2021.114450] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/14/2021] [Accepted: 10/27/2021] [Indexed: 11/15/2022]
Abstract
Carboxylic acid containing compounds (R-COOH) are involved in a large number of biological processes and they are relevant for several pathological processes such as neurodegeneration or cancer. Comprehensive methodologies for the quantitative determination of R-COOH in biological samples are required. In this study we have developed a LC-MS/MS method for the quantification of 20 endogenous R-COOH belonging to different pathways such as kynurenine metabolism, serotoninergic pathway, glycolysis, tricarboxylic acid cycle, dopaminergic pathway, short chain fatty acids and glycine metabolism. The approach included derivatization with o-benzylhydroxylamine (reaction time 1 h), liquid-liquid extraction with ethyl acetate and LC-MS/MS detection (run time 10 min). The method was optimized and validated in 5 different matrices (urine, plasma, saliva, brain and liver) following two different approaches: (i) using surrogate matrices and (ii) using actual human samples by standard additions. A suitable linearity was obtained in the endogenous range of the analytes. Adequate intra and inter-assay accuracies (80-120%) and intra- and inter-assay precisions (<20%) were achieved for almost all analytes in all studied matrices. The method was applied in several scenarios to confirm (i) human urinary changes produced in glycolysis after exercise, (ii) metabolic changes produced in rat brain and plasma by methamphetamine administration and (iii) metabolic alterations in human plasma caused by vitamin B6 deficiency. Additionally, the application of the method allowed for establishing previously unreported alterations in R-COOH metabolites under these conditions. Due to the comprehensive analyte and matrix coverage and the wide applicability of the developed methodology, it can be considered as a suitable tool for the study of R-COOH status in health and disease by targeted metabolomics.
Collapse
Affiliation(s)
- Alex Gomez-Gomez
- Applied Metabolomics Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain; Integrative Pharmacology & Systems Neuroscience Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain; Universitat Pompeu Fabra (CEXS-UPF), Doctor Aiguader 88, Barcelona, Spain
| | - Eulàlia Olesti
- Applied Metabolomics Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain; Integrative Pharmacology & Systems Neuroscience Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain
| | | | - Angie Soldevila
- Applied Metabolomics Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain
| | - Tessa Deschamps
- Applied Metabolomics Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain
| | - Nieves Pizarro
- Integrative Pharmacology & Systems Neuroscience Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain
| | - Rafael de la Torre
- Applied Metabolomics Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain; Integrative Pharmacology & Systems Neuroscience Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain; Universitat Pompeu Fabra (CEXS-UPF), Doctor Aiguader 88, Barcelona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN, CB06/03/028), 15706 Santiago de Compostela, Spain
| | - Oscar J Pozo
- Applied Metabolomics Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain; Integrative Pharmacology & Systems Neuroscience Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, Barcelona, Spain.
| |
Collapse
|
7
|
Kim HY, Lee YJ, Kim SJ, Lee JD, Kim S, Ko MJ, Kim JW, Shin CY, Kim KB. Metabolomics profiling of valproic acid-induced symptoms resembling autism spectrum disorders using 1H NMR spectral analysis in rat model. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2022; 85:1-13. [PMID: 34445937 DOI: 10.1080/15287394.2021.1967821] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Prenatal exposure to valproic acid (VPA) has been implicated in the manifestation of autism spectrum disorder (ASD)-like behavioral and functional changes both in human and rodents including mice and rats. The objective of this study was to determine metabolomics profiling and biomarkers related to VPA-induced symptoms resembling ASD using proton nuclear magnetic resonance (1H-NMR) spectral data. VPA was administered to pregnant rats at gestation day 12.5 and effects measured subsequently in male 4-week-old offspring pups. The sociability of VPA-treated animals was significantly diminished and exhibited ASD-like behavior as evidenced by reduction of social adaptation disorder and lack of social interactions. To find biomarkers related to ASD, the following were collected prefrontal brain cortices, urine bladder and blood samples directly from heart puncture. In all samples, principal component analysis (PCA) and partial least-squares discriminant analysis (PLS-DA) displayed significant clustering pattern differences between control and treated groups. Valine, taurine, myo-inositol, 3-hydroxybutyrate and 1,3-dihydroxyacetone were significantly decreased in brain cortices in treated rats. Serum metabolites of glucose, creatine phosphate, lactate, glutamine and threonine were significantly increased in VPA-administered animals. Urinary metabolites of pimelate, 3-hydroxyisovalerate and valerate were significantly reduced in VPA-treated rat, whereas galactose and galactonate levels were elevated. Various metabolites were associated with mitochondrial dysfunction metabolism and central nervous system disorders. Data demonstrated that VPA-induced alterations in endogenous metabolites of serum, urine, and brain cortex which might prove useful as biomarkers for symptoms resembling ASD as a model of this disorder.
Collapse
Affiliation(s)
- Hyang Yeon Kim
- College of Pharmacy, Dankook University, Cheonan, Chungnam, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Cheonan, Chungnam Republic of Korea
| | - Yong-Jae Lee
- College of Pharmacy, Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Sun Jae Kim
- College of Pharmacy, Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Jung Dae Lee
- College of Pharmacy, Dankook University, Cheonan, Chungnam, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Cheonan, Chungnam Republic of Korea
| | - Suhkmann Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan Republic of Korea
| | - Mee Jung Ko
- Department Of Neuroscience, School Of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Ji-Woon Kim
- Department Of Neuroscience, School Of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Chan Young Shin
- Department Of Neuroscience, School Of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Kyu-Bong Kim
- College of Pharmacy, Dankook University, Cheonan, Chungnam, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Cheonan, Chungnam Republic of Korea
| |
Collapse
|
8
|
Mukherjee S, Kotnis A, Ray SK, Vaidyanathan K, Singh S, Mittal R. Current Scenario of Clinical Diagnosis to Identify Inborn Errors of Metabolism with Precision Profiling for Expanded Screening in Infancy in a Resource-limited Setting. Curr Pediatr Rev 2022; 19:34-47. [PMID: 35379152 DOI: 10.2174/1573396318666220404113732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/18/2022] [Accepted: 02/15/2022] [Indexed: 01/28/2023]
Abstract
Inborn errors of metabolism (IEM) are a diverse collection of abnormalities that cause a variety of morbidities and mortality in children and are classified as uncommon genetic diseases. Early and accurate detection of the condition can save a patient's life. By aiding families as they navigate the experience of having a child with an IEM, healthcare practitioners have the chance to reduce the burden of negative emotional consequences. New therapeutic techniques, such as enzyme replacement and small chemical therapies, organ transplantation, and cellular and gene-based therapies using whole-genome sequencing, have become available in addition to traditional medical intake and cofactor treatments. In the realm of metabolic medicine and metabolomics, the twentyfirst century is an exciting time to be alive. The availability of metabolomics and genomic analysis has led to the identification of a slew of novel diseases. Due to the rarity of individual illnesses, obtaining high-quality data for these treatments in clinical trials and real-world settings has proven difficult. Guidelines produced using standardized techniques have helped enhance treatment delivery and clinical outcomes over time. This article gives a comprehensive description of IEM and how to diagnose it in patients who have developed clinical signs early or late. The appropriate use of standard laboratory outcomes in the preliminary patient assessment is also emphasized that can aid in the ordering of specific laboratory tests to confirm a suspected diagnosis, in addition, to begin treatment as soon as possible in a resource limiting setting where genomic analysis or newborn screening facility is not available.
Collapse
Affiliation(s)
- Sukhes Mukherjee
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh-462020, India
| | - Ashwin Kotnis
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh-462020, India
| | | | - Kannan Vaidyanathan
- Department of Biochemistry, Amrita Institute of Medical Science & Research Center, Kochi, Kerala-682041, India
| | - Snighdha Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh-462020, India
| | - Rishabh Mittal
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh-462020, India
| |
Collapse
|
9
|
Kumar Dalei S, Adlakha N. Food Regime for Phenylketonuria: Presenting Complications and Possible Solutions. J Multidiscip Healthc 2022; 15:125-136. [PMID: 35082498 PMCID: PMC8785131 DOI: 10.2147/jmdh.s330845] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022] Open
Abstract
In the category of rare inherited genetic disorders, phenylketonuria is a prominent example. Here, the defective phenylalanine hydroxylase enzyme fails to catalyze conversion of phenylalanine to tyrosine. This leads to not only excess deposition of phenylalanine leading to phenylalanine toxicity but also precludes the production of important glutamatergic and cholinergic neurotransmitters, leading to epileptic disorders, microcephaly, low intelligence quotient etc. For long, specialized food products are considered as preferred solution to prevent disease outcome. Different medical diets are developed for managing phenylketonuria includes amino acid mixtures, protein hydrolysates, cofactor-based therapy, large neutral amino acids and glycomacropeptides. However, despite the advent of alternate forms of diet products, the central form of treatment has still been free amino acid mixture. The formulated diet is by and large expensive and in-depth evaluation of several factors which contribute to the expense of medicated diet is requisite to create effective yet affordable avenues for management of disease. For this, we have discussed the role of various factors involved in increasing price of medicated diet and presented possible solutions to it. We have also extensively reviewed prevalence of disease, commercial diet for PKU patients, and their associated limitations. Overall, this is the first attempt to present a holistic view of balance between the overall impact of diet associated therapy and weighing it against the associated finances incurred.
Collapse
Affiliation(s)
- Sudipt Kumar Dalei
- Regional Center for Biotechnology, NCR Biotech Science Cluster, Faridabad, Haryana, India
| | - Nidhi Adlakha
- Regional Center for Biotechnology, NCR Biotech Science Cluster, Faridabad, Haryana, India
- Correspondence: Nidhi Adlakha Email
| |
Collapse
|
10
|
Zhou M, Deng L, Huang Y, Xiao Y, Wen J, Liu N, Zeng Y, Zhang H. Application of the Artificial Intelligence Algorithm Model for Screening of Inborn Errors of Metabolism. Front Pediatr 2022; 10:855943. [PMID: 35664874 PMCID: PMC9160361 DOI: 10.3389/fped.2022.855943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Inborn errors of metabolism (IEMs) are strongly related to abnormal growth and development in newborns and can even result in death. In total, 94,648 newborns were enrolled for expanded newborn screening using tandem mass spectrometry (MS/MS) from 2016 to 2020 at the Neonatal Disease Screening Center of the Maternal and Child Health Hospital in Shaoyang City, China. A total of 23 confirmed cases were detected in our study with an incidence rate of 1:4,115. A total of 10 types of IEM were identified, and the most common IEMs were phenylalanine hydroxylase deficiency (PAHD; 1:15,775) and primary carnitine deficiency (PCD; 1:18,930). Mutations in phenylalanine hydroxylase (PAH) and SLC22A5 were the leading causes of IEMs. To evaluate the application effect of artificial intelligence (AI) in newborn screening, we used AI to retrospectively analyze the screening results and found that the false-positive rate could be decreased by more than 24.9% after using AI. Meanwhile, a missed case with neonatal intrahepatic cholestasis citrin deficiency (NICCD) was found, the infant had a normal citrulline level (31 μmol/L; cutoff value of 6-32 μmol/L), indicating that citrulline may not be the best biomarker of intrahepatic cholestasis citrin deficiency. Our results indicated that the use of AI in newborn screening could improve efficiency significantly. Hence, we propose a novel strategy that combines expanded neonatal IEM screening with AI to reduce the occurrence of false positives and false negatives.
Collapse
Affiliation(s)
- Muping Zhou
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Liyuan Deng
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Yan Huang
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Ying Xiao
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Jun Wen
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Na Liu
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Yingchao Zeng
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| | - Hua Zhang
- Neonatal Disease Screening Center, The Maternal and Child Health Hospital of Shaoyang City, Shaoyang, China
| |
Collapse
|
11
|
Huang Z, Hu Z, Tu C, Huang X, Liu H, Zhang Y. Rapid screening for organic acidurias based on abnormal patterns of organic acids in neonatal urine by tandem mass spectrometry with automated flow injection. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
12
|
Shetty PP, Jacob P, Shenoy RP, Nalini K. Use of single solvent thin layer chromatography to diagnose different organic acidurias. Indian J Med Res 2021; 154:150-153. [PMID: 34782541 PMCID: PMC8715692 DOI: 10.4103/ijmr.ijmr_1402_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Prajna P Shetty
- Department of Biochemistry, Kasturba Medical College & Hospital, Manipal 576 104, Karnataka, India
| | - Prince Jacob
- Department of Medical Genetics, Kasturba Medical College & Hospital, Manipal 576 104, Karnataka, India
| | - Revathi P Shenoy
- Department of Biochemistry, Kasturba Medical College & Hospital, Manipal 576 104, Karnataka, India
| | - K Nalini
- Department of Biochemistry, Kasturba Medical College & Hospital, Manipal 576 104, Karnataka, India
| |
Collapse
|
13
|
Godsora BKJ, Prakash P, Punekar NS, Bhaumik P. Molecular insights into the inhibition of glutamate dehydrogenase by the dicarboxylic acid metabolites. Proteins 2021; 90:810-823. [PMID: 34748226 DOI: 10.1002/prot.26276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/20/2022]
Abstract
Glutamate dehydrogenase (GDH) is a salient metabolic enzyme which catalyzes the NAD+ - or NADP+ -dependent reversible conversion of α-ketoglutarate (AKG) to l-glutamate; and thereby connects the carbon and nitrogen metabolism cycles in all living organisms. The function of GDH is extensively regulated by both metabolites (citrate, succinate, etc.) and non-metabolites (ATP, NADH, etc.) but sufficient molecular evidences are lacking to rationalize the inhibitory effects by the metabolites. We have expressed and purified NADP+ -dependent Aspergillus terreus GDH (AtGDH) in recombinant form. Succinate, malonate, maleate, fumarate, and tartrate independently inhibit the activity of AtGDH to different extents. The crystal structures of AtGDH complexed with the dicarboxylic acid metabolites and the coenzyme NADPH have been determined. Although AtGDH structures are not complexed with substrate; surprisingly, they acquire super closed conformation like previously reported for substrate and coenzyme bound catalytically competent Aspergillus niger GDH (AnGDH). These dicarboxylic acid metabolites partially occupy the same binding pocket as substrate; but interact with varying polar interactions and the coenzyme NADPH binds to the Domain-II of AtGDH. The low inhibition potential of tartrate as compared to other dicarboxylic acid metabolites is due to its weaker interactions of carboxylate groups with AtGDH. Our results suggest that the length of carbon skeleton and positioning of the carboxylate groups of inhibitors between two conserved lysine residues at the GDH active site might be the determinants of their inhibitory potency. Molecular details on the dicarboxylic acid metabolites bound AtGDH active site architecture presented here would be applicable to GDHs in general.
Collapse
Affiliation(s)
| | - Prem Prakash
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Narayan S Punekar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Prasenjit Bhaumik
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| |
Collapse
|
14
|
Orthopaedic Problems in 35 Patients With Organic Acid Disorders. J Pediatr Orthop 2021; 41:e457-e463. [PMID: 34096551 DOI: 10.1097/bpo.0000000000001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Organic acid disorders (OADs) are a subset of inborn errors of metabolism that result in a toxic accumulation of organic acids in the body, which can lead to metabolic derangements and encephalopathy. Patients with these disorders are managed by a team of biochemical geneticists and metabolic nutritionists. However, subspecialists such as neurologists and orthopaedic surgeons are often needed to help manage the sequelae of the metabolic derangements. The breadth of orthopaedic sequelae of these disease states is poorly understood. Herein, we describe orthopaedic problems associated with 5 types of OAD most commonly seen at our institution: maple syrup urine disease, methylmalonic aciduria, propionic aciduria, pyruvate dehydrogenase deficiency, and glutaric aciduria type 1. METHODS We retrospectively reviewed medical records of 35 patients with an OAD who were seen at our academic tertiary care center from May 1999 to May 2020. Patients were grouped into cohorts according to OAD type and analyzed for orthopaedic presentations of hip, knee, or foot disorders, presence and severity of scoliosis, history of fracture, movement disorders, and osteopenia/osteoporosis. RESULTS Of the 35 patients, 13 had maple syrup urine disease, 12 had methylmalonic aciduria, 4 had propionic aciduria, 4 had pyruvate dehydrogenase deficiency, and 2 had glutaric aciduria type 1. Associated orthopaedic problems included spasticity causing neuromuscular scoliosis and/or hip subluxation or dislocation (10 patients), fractures (7 patients), and osteopenia/osteoporosis (7 patients). Overall, 22 of 35 patients had some orthopaedic condition. CONCLUSIONS Most in this cohort of patients with OAD also had an orthopaedic abnormality. It is important for physicians treating these patients to understand their propensity for musculoskeletal problems. When treating patients with OAD, it is important to initiate and maintain communication with specialists in several disciplines and to develop collaborative treatments for this unique population. LEVEL OF EVIDENCE Level IV-prognostic study.
Collapse
|
15
|
Akin EÖ, Pekcici BB, Eminoglu FT. International classification of functioning, disability and health framework (ICF) based adaptive functioning outcomes of children with organic acidemias from a middle-income country. Brain Dev 2021; 43:389-395. [PMID: 33309492 DOI: 10.1016/j.braindev.2020.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The World Health Organization International Classification of Functioning, Disability and Health Framework (ICF) states that a child's health conditions, functions, activities, participation in life and contextual factors shape disability. Research on the development of children with organic acidemias (OA) mostly focused on cognitive and medical outcomes. This study aimed to examine adaptive functioning of children with OAs based on ICF. METHODS In this cross-sectional study, children with propionic academia, methylmalonic acidemia and maple syrup urine disease receiving care at Ankara University School of Medicine, Department of Pediatrics, Pediatric Metabolism Division were recruited. Comprehensive developmental assessments included ICF-based methods. Adaptive functioning was measured with Vineland Adaptive Behavior Scales-Second Edition. RESULTS The sample comprised 22 children with a median age of 47.5 months (IQR: 35-73.5). Most mothers (64%) had less than 5 years of education, half had depression. Two children (9%) were attending to school, 14 (64%) were not regularly playing with friends. Fourteen children (64%) had significant communication delays, 12 (55%) had significant problems in daily living skills, and 12 (55%) in social skills. Mean adaptive behavior composite score was 65.5 ± 16.8 (low), children with feeding disorders had significantly more low adaptive behavior composite scores than children with no feeding disorder diagnosis (p = 0.001). CONCLUSIONS Our results imply that children with OAs from Turkey, a middle-income country had major difficulties in functioning, activities, participation and contextual factors. Feeding problems appeared as a risk factor for lower adaptive functioning. ICF-based assessments and interventions are urgently needed in the management of children with OAs.
Collapse
Affiliation(s)
- Ezgi Özalp Akin
- Ankara University School of Medicine, Department of Pediatrics, Developmental-Behavioral Pediatrics Division, Turkey.
| | - Bahar Bingoler Pekcici
- Ankara University School of Medicine, Department of Pediatrics, Developmental-Behavioral Pediatrics Division, Turkey
| | - Fatma Tuba Eminoglu
- Ankara University School of Medicine, Department of Pediatrics, Pediatric Metabolism Division, Turkey
| |
Collapse
|
16
|
Rossi C, Cicalini I, Rizzo C, Zucchelli M, Consalvo A, Valentinuzzi S, Semeraro D, Gasparroni G, Brindisino P, Gazzolo D, Dionisi-Vici C, De Laurenzi V, Pieragostino D. A False-Positive Case of Methylmalonic Aciduria by Tandem Mass Spectrometry Newborn Screening Dependent on Maternal Malnutrition in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103601. [PMID: 32443888 PMCID: PMC7277087 DOI: 10.3390/ijerph17103601] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/16/2020] [Accepted: 05/17/2020] [Indexed: 12/18/2022]
Abstract
Methylmalonic Acidurias (MMAs) are a group of inborn errors of metabolism (IEMs), specifically of propionate catabolism characterized by gastrointestinal and neurometabolic manifestations resulting from a deficiency in the function of methylmalonyl-CoA mutase, methylmalonyl-CoA epimerase, and cobalamin metabolism. In Expanded Newborn Screening (NBS), increased levels of propionylcarnitine (C3) and/or of its ratios by MS/MS analysis of dried blood spots (DBS) samples are suggestive for either Propionic Acidemia or MMAs. C3 elevation is not considered a specific marker for these disorders, resulting in high false-positive rates. The use of analyte ratios improves specificity, but it still cannot resolve the diagnostic issue. Second-tier testing are strongly recommended as confirmation of primary NBS results and for a differential diagnosis. LC-MS/MS analysis allows the quantification of more specific markers of the disorder. Here, we report the case of a newborn with a suspected MMA at Expanded NBS and at second-tier test. Given the urgent situation, in-depth diagnostic investigations were performed. Further investigations surprisingly revealed a Vitamin B12 deficiency due to a maternal malnutrition during pregnancy. This case emphasized that metabolic alterations at NBS may not only be influenced by genome and related to IEMs, but also to external factors and to maternal conditions.
Collapse
Affiliation(s)
- Claudia Rossi
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medicine and Aging Science, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: ; Tel.: +39-0871-541596; Fax: +39-0871-541598
| | - Ilaria Cicalini
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medicine and Aging Science, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
| | - Cristiano Rizzo
- Metabolic Diseases Unit, Bambino Gesù Children Hospital and Research Institute, 00165 Rome, Italy; (C.R.); (C.D.-V.)
| | - Mirco Zucchelli
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Ada Consalvo
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Silvia Valentinuzzi
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Pharmacy, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Daniela Semeraro
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medicine and Aging Science, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
| | - Giorgia Gasparroni
- Neonatal Intensive Care Unit, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.G.); (P.B.)
| | - Patrizia Brindisino
- Neonatal Intensive Care Unit, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.G.); (P.B.)
| | - Diego Gazzolo
- Department of Medicine and Aging Science, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
- Neonatal Intensive Care Unit, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.G.); (P.B.)
| | - Carlo Dionisi-Vici
- Metabolic Diseases Unit, Bambino Gesù Children Hospital and Research Institute, 00165 Rome, Italy; (C.R.); (C.D.-V.)
| | - Vincenzo De Laurenzi
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Damiana Pieragostino
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (I.C.); (M.Z.); (A.C.); (S.V.); (D.S.); (V.D.L.); or (D.P.)
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| |
Collapse
|
17
|
WU D, LU B, YANG J, YANG R, HUANG X, TONG F, ZHENG J, ZHAO Z. [Genetic analysis of newborns with abnormal metabolism of 3-hydroxyisovalerylcarnitine]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2019; 48:390-396. [PMID: 31901042 PMCID: PMC8800779 DOI: 10.3785/j.issn.1008-9292.2019.08.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the genetic characterization of 3-hydroxyisovalerylcarnitine (C5-OH) metabolic abnormality in neonates. METHODS Fifty two newborns with increased C5-OH, C5-OH/C3 and C5-OH/C8 detected by tandem mass spectrometry during neonatal screening were enrolled in the study. Genomic DNA was extracted from the whole blood samples of 52 cases and their parents. Seventy-nine genes associated with genetic and metabolic diseases including MCCC1, MCCC2 were targeted by liquid capture technique. Variation information of these genes was examined by high-throughput sequencing and bioinformatic analysis, and then was classified based on the American College of Medical Genetics and Genomics (ACMG) standards and guidelines. The genetic types were classified as wild-type, MCCC1-maternal-mutation, MCCC1-paternal-mutation and MCCC2-mutation. Wilcoxon rank-sum test was performed for the increased multiples of C5-OH calculated in neonatal screening. RESULTS Twenty one MCCC1 variants (14 novel) were identified in 37 cases, 6 MCCC2 variants (5 novel) in 4 cases. The increased multiple of C5-OH calculated in MCCC1-maternal-mutation and MCCC2-mutation groups were significantly higher than that in wild-type group (all P<0.05), while there was no significant difference between MCCC1-paternal-mutation group and wild-type group (P>0.05). CONCLUSIONS Mutations on MCCC1 and MCCC2 genes are the major genetic causes for the increased C5-OH in neonates, and maternal single heterozygous mutation can contribute to the moderately to severely increased C5-OH.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Zhengyan ZHAO
- 赵正言(1953—), 男, 硕士, 教授, 博士生导师, 主要从事遗传代谢病和儿童保健学研究; E-mail:
;
https://orcid.org/0000-0001-8626-2578
| |
Collapse
|
18
|
Tanacan A, Gurbuz BB, Aydin E, Erden M, Coskun T, Beksac MS. Prenatal Diagnosis of Organic Acidemias at a Tertiary Center. Balkan J Med Genet 2019; 22:29-34. [PMID: 31523617 PMCID: PMC6714333 DOI: 10.2478/bjmg-2019-0003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to share our experience in the prenatal diagnosis (PND) of organic acidemias (OAs) in our clinic. This study consisted of 10 cases in whom an invasive prenatal diagnostic test (IPNDT) was performed by a single physician for the PND of OAs. Median maternal age, parity, gestational week of IPNDT, prenatal test indications, OA types, method of IPNDT, IPNDT results and gestational outcomes were evaluated. Targeted mutation analysis was performed in fetal DNA for the specific mutations by using polymerase chain reaction (PCR) and direct Sanger sequencing. The diagnosis was confirmed by genetic targeted mutation analysis after birth. Median maternal age, parity and gestational week of IPNDT values were 30 (range 21-35), one (range 0-4) and 11.5 (range 11-17), respectively. Indications for IPNDT were mother being a carrier of the disease for one case (10.0%) and at least one child with OA in the family for nine cases (90.0%). Organic acidemia types investigated were maple syrup urine disease (MSUD), methylmalonic acidemia (MMA) and isovaleric acidemia (IVA) in five (50.0%), three (30.0%) and two (20.0%) patients, respectively. Chorion villus sampling (CVS) was done in seven (70.0%) patients and amniocentesis was performed in three (30.0%) patients. Eight fetuses (80.0%) were found to be healthy and two fetuses (20.0%) were found to be affected (one case with IVA and one case with MMA). The two pregnancies (20.0%) with affected fetuses were terminated. Prenatal diagnosis of OAs is critical. Appropriate prenatal counseling should be given to families with known risk factors.
Collapse
Affiliation(s)
- A Tanacan
- Department of Obstetrics and Gynecology, Division of Perinatology, Hacettepe University Hospital, Ankara, Turkey
| | - BB Gurbuz
- Department of Pediatrics, Division of Pediatric Metabolism, Hacettepe University Hospital, Ankara, Turkey
| | - E Aydin
- Department of Obstetrics and Gynecology, Division of Perinatology, Hacettepe University Hospital, Ankara, Turkey
| | - M Erden
- Department of Obstetrics and Gynecology, Division of Perinatology, Hacettepe University Hospital, Ankara, Turkey
| | - T Coskun
- Department of Pediatrics, Division of Pediatric Metabolism, Hacettepe University Hospital, Ankara, Turkey
| | - MS Beksac
- Department of Obstetrics and Gynecology, Division of Perinatology, Hacettepe University Hospital, Ankara, Turkey
| |
Collapse
|