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Safran A, Proskorovski-Ohayon R, Eskin-Schwartz M, Yogev Y, Drabkin M, Eremenko E, Aharoni S, Freund O, Jean MM, Agam N, Hadar N, Loewenthal N, Staretz-Chacham O, Birk OS. Hyperinsulinism/hyperammonemia syndrome caused by biallelic SLC25A36 mutation. J Inherit Metab Dis 2023; 46:744-755. [PMID: 36695547 DOI: 10.1002/jimd.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 01/06/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
Hyperinsulinism/hyperammonemia (HI/HA) syndrome has been known to be caused by dominant gain-of-function mutations in GLUD1, encoding the mitochondrial enzyme glutamate dehydrogenase. Pathogenic GLUD1 mutations enhance enzymatic activity by reducing its sensitivity to allosteric inhibition by GTP. Two recent independent studies showed that a similar HI/HA phenotype can be caused by biallelic mutations in SLC25A36, encoding pyrimidine nucleotide carrier 2 (PNC2), a mitochondrial nucleotide carrier that transports pyrimidine and guanine nucleotides across the inner mitochondrial membrane: one study reported a single case caused by a homozygous truncating mutation in SLC25A36 resulting in lack of expression of SLC25A36 in patients' fibroblasts. A second study described two siblings with a splice site mutation in SLC25A36, causing reduction of mitochondrial GTP content, putatively leading to hyperactivation of glutamate dehydrogenase. In an independent study, through combined linkage analysis and exome sequencing, we demonstrate in four individuals of two Bedouin Israeli related families the same disease-causing SLC25A36 (NM_018155.3) c.284 + 3A > T homozygous splice-site mutation found in the two siblings. We demonstrate that the mutation, while causing skipping of exon 3, does not abrogate expression of mRNA and protein of the mutant SLC25A36 in patients' blood and fibroblasts. Affected individuals had hyperinsulinism, hyperammonemia, borderline low birth weight, tonic-clonic seizures commencing around 6 months of age, yet normal intellect and no significant other morbidities. Chronic constipation, hypothyroidism, and developmental delay previously described in a single patient were not found. We thus verify that biallelic SLC25A36 mutations indeed cause HI/HA syndrome and clearly delineate the disease phenotype.
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Affiliation(s)
- Amit Safran
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Regina Proskorovski-Ohayon
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Marina Eskin-Schwartz
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
- Genetics Institute, Soroka Medical Center, Beer Sheva, Israel
| | - Yuval Yogev
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Max Drabkin
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Ekaterina Eremenko
- Department of Life Sciences and Shraga Segal Department of Microbiology, Immunology and Genetics, National Institute of Biotechnology in the Negev, Zlotowski Neuroscience Center and the Regenerative Medicine and Stem Cell Research Center, Ben-Gurion University, Beer Sheva, Israel
| | - Sarit Aharoni
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Ofek Freund
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Matan M Jean
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Nadav Agam
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Noam Hadar
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
| | - Neta Loewenthal
- Pediatric Endocrinology Unit, Pediatric Division, Soroka Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
| | - Orna Staretz-Chacham
- Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
- Pediatric Metabolic Clinic, Pediatric Division, Soroka Medical Center, Ben-Gurion University, Beer Sheva, Israel
| | - Ohad S Birk
- Morris Kahn Laboratory of Human Genetics at the Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences and National Institute for Biotechnology in the Negev, Ben Gurion University, Beer Sheva, Israel
- Genetics Institute, Soroka Medical Center, Beer Sheva, Israel
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Shahroor MA, Lasorsa FM, Porcelli V, Dweikat I, Di Noia MA, Gur M, Agostino G, Shaag A, Rinaldi T, Gasparre G, Guerra F, Castegna A, Todisco S, Abu-Libdeh B, Elpeleg O, Palmieri L. PNC2 ( SLC25A36) Deficiency Associated With the Hyperinsulinism/Hyperammonemia Syndrome. J Clin Endocrinol Metab 2022; 107:1346-1356. [PMID: 34971397 DOI: 10.1210/clinem/dgab932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The hyperinsulinism/hyperammonemia (HI/HA) syndrome, the second-most common form of congenital hyperinsulinism, has been associated with dominant mutations in GLUD1, coding for the mitochondrial enzyme glutamate dehydrogenase, that increase enzyme activity by reducing its sensitivity to allosteric inhibition by GTP. OBJECTIVE To identify the underlying genetic etiology in 2 siblings who presented with the biochemical features of HI/HA syndrome but did not carry pathogenic variants in GLUD1, and to determine the functional impact of the newly identified mutation. METHODS The patients were investigated by whole exome sequencing. Yeast complementation studies and biochemical assays on the recombinant mutated protein were performed. The consequences of stable slc25a36 silencing in HeLa cells were also investigated. RESULTS A homozygous splice site variant was identified in solute carrier family 25, member 36 (SLC25A36), encoding the pyrimidine nucleotide carrier 2 (PNC2), a mitochondrial nucleotide carrier that transports pyrimidine as well as guanine nucleotides across the inner mitochondrial membrane. The mutation leads to a 26-aa in-frame deletion in the first repeat domain of the protein, which abolishes transport activity. Furthermore, knockdown of slc25a36 expression in HeLa cells caused a marked reduction in the mitochondrial GTP content, which likely leads to a hyperactivation of glutamate dehydrogenase in our patients. CONCLUSION We report for the first time a mutation in PNC2/SLC25A36 leading to HI/HA and provide functional evidence of the molecular mechanism responsible for this phenotype. Our findings underscore the importance of mitochondrial nucleotide metabolism and expand the role of mitochondrial transporters in insulin secretion.
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Affiliation(s)
- Maher A Shahroor
- Department of Pediatrics and Genetics, Al Makassed Hospital and Al-Quds University, 95908 Jerusalem, Palestine
- Department of Neonatology, Sunnybrook Health Sciences Center, University of Toronto, M4N 3M5 Toronto, Canada
| | - Francesco M Lasorsa
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
- CNR Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, 70125 Bari, Italy
| | - Vito Porcelli
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Imad Dweikat
- Metabolic Unit, An-Najah National University, P467 Nablus, Palestine
| | - Maria Antonietta Di Noia
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Michal Gur
- Department of Genetics, Hadassah, Hebrew University Medical Center, 91120 Jerusalem, Israel
| | - Giulia Agostino
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Avraham Shaag
- Department of Genetics, Hadassah, Hebrew University Medical Center, 91120 Jerusalem, Israel
| | - Teresa Rinaldi
- Pasteur Institute-Cenci Bolognetti Foundation, Department of Biology and Biotechnology "Charles Darwin", University of Rome La Sapienza, 00185 Rome, Italy
| | - Giuseppe Gasparre
- Department of Medical and Surgical Sciences (DIMEC), Unit of Medical Genetics and Center for Applied Biomedical Research (CRBA), University of Bologna, 40138 Bologna, Italy
| | - Flora Guerra
- Department of Medical and Surgical Sciences (DIMEC), Unit of Medical Genetics and Center for Applied Biomedical Research (CRBA), University of Bologna, 40138 Bologna, Italy
| | - Alessandra Castegna
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
- CNR Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, 70125 Bari, Italy
| | - Simona Todisco
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
| | - Bassam Abu-Libdeh
- Department of Pediatrics and Genetics, Al Makassed Hospital and Al-Quds University, 95908 Jerusalem, Palestine
| | - Orly Elpeleg
- Department of Genetics, Hadassah, Hebrew University Medical Center, 91120 Jerusalem, Israel
| | - Luigi Palmieri
- Laboratory of Biochemistry and Molecular Biology, Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari Aldo Moro, 70125 Bari, Italy
- CNR Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, 70125 Bari, Italy
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Jasper L, Scarcia P, Rust S, Reunert J, Palmieri F, Marquardt T. Uridine Treatment of the First Known Case of SLC25A36 Deficiency. Int J Mol Sci 2021; 22:ijms22189929. [PMID: 34576089 PMCID: PMC8470663 DOI: 10.3390/ijms22189929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/16/2022] Open
Abstract
SLC25A36 is a pyrimidine nucleotide carrier playing an important role in maintaining mitochondrial biogenesis. Deficiencies in SLC25A36 in mouse embryonic stem cells have been associated with mtDNA depletion as well as mitochondrial dysfunction. In human beings, diseases triggered by SLC25A36 mutations have not been described yet. We report the first known case of SLC25A36 deficiency in a 12-year-old patient with hypothyroidism, hyperinsulinism, hyperammonemia, chronical obstipation, short stature, along with language and general developmental delay. Whole exome analysis identified the homozygous mutation c.803dupT, p.Ser269llefs*35 in the SLC25A36 gene. Functional analysis of mutant SLC25A36 protein in proteoliposomes showed a virtually abolished transport activity. Immunoblotting results suggest that the mutant SLC25A36 protein in the patient undergoes fast degradation. Supplementation with oral uridine led to an improvement of thyroid function and obstipation, increase of growth and developmental progress. Our findings suggest an important role of SLC25A36 in hormonal regulations and oral uridine as a safe and effective treatment.
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Affiliation(s)
- Luisa Jasper
- Department of Pediatrics, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude A13, 48149 Münster, Germany; (L.J.); (S.R.); (J.R.)
| | - Pasquale Scarcia
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Via Orabona 4, 70125 Bari, Italy;
| | - Stephan Rust
- Department of Pediatrics, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude A13, 48149 Münster, Germany; (L.J.); (S.R.); (J.R.)
| | - Janine Reunert
- Department of Pediatrics, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude A13, 48149 Münster, Germany; (L.J.); (S.R.); (J.R.)
| | - Ferdinando Palmieri
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Via Orabona 4, 70125 Bari, Italy;
- Correspondence: (F.P.); (T.M.)
| | - Thorsten Marquardt
- Department of Pediatrics, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude A13, 48149 Münster, Germany; (L.J.); (S.R.); (J.R.)
- Correspondence: (F.P.); (T.M.)
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Di Noia MA, Todisco S, Cirigliano A, Rinaldi T, Agrimi G, Iacobazzi V, Palmieri F. The human SLC25A33 and SLC25A36 genes of solute carrier family 25 encode two mitochondrial pyrimidine nucleotide transporters. J Biol Chem 2014; 289:33137-48. [PMID: 25320081 DOI: 10.1074/jbc.m114.610808] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The human genome encodes 53 members of the solute carrier family 25 (SLC25), also called the mitochondrial carrier family, many of which have been shown to transport inorganic anions, amino acids, carboxylates, nucleotides, and coenzymes across the inner mitochondrial membrane, thereby connecting cytosolic and matrix functions. Here two members of this family, SLC25A33 and SLC25A36, have been thoroughly characterized biochemically. These proteins were overexpressed in bacteria and reconstituted in phospholipid vesicles. Their transport properties and kinetic parameters demonstrate that SLC25A33 transports uracil, thymine, and cytosine (deoxy)nucleoside di- and triphosphates by an antiport mechanism and SLC25A36 cytosine and uracil (deoxy)nucleoside mono-, di-, and triphosphates by uniport and antiport. Both carriers also transported guanine but not adenine (deoxy)nucleotides. Transport catalyzed by both carriers was saturable and inhibited by mercurial compounds and other inhibitors of mitochondrial carriers to various degrees. In confirmation of their identity (i) SLC25A33 and SLC25A36 were found to be targeted to mitochondria and (ii) the phenotypes of Saccharomyces cerevisiae cells lacking RIM2, the gene encoding the well characterized yeast mitochondrial pyrimidine nucleotide carrier, were overcome by expressing SLC25A33 or SLC25A36 in these cells. The main physiological role of SLC25A33 and SLC25A36 is to import/export pyrimidine nucleotides into and from mitochondria, i.e. to accomplish transport steps essential for mitochondrial DNA and RNA synthesis and breakdown.
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Affiliation(s)
- Maria Antonietta Di Noia
- From the Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona 4, 70125 Bari, Italy, Department of Sciences, University of Basilicata, via N. Sauro 85, 85100 Potenza, Italy
| | - Simona Todisco
- From the Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona 4, 70125 Bari, Italy
| | - Angela Cirigliano
- Pasteur Institute-Cenci Bolognetti Foundation, Department of Biology and Biotechnology "Charles Darwin," University of Rome La Sapienza, 00185 Rome, Italy, Associazione Gian Franco Lupo "Un Sorriso alla Vita," ASM Azienda Sanitaria Locale di Matera, via Montescaglioso 75100 Matera, Italy, and
| | - Teresa Rinaldi
- Pasteur Institute-Cenci Bolognetti Foundation, Department of Biology and Biotechnology "Charles Darwin," University of Rome La Sapienza, 00185 Rome, Italy
| | - Gennaro Agrimi
- From the Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona 4, 70125 Bari, Italy
| | - Vito Iacobazzi
- From the Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona 4, 70125 Bari, Italy, Center of Excellence in Comparative Genomics, University of Bari, via Orabona 4, 70125 Bari, Italy
| | - Ferdinando Palmieri
- From the Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, via Orabona 4, 70125 Bari, Italy, Center of Excellence in Comparative Genomics, University of Bari, via Orabona 4, 70125 Bari, Italy
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