Maple syrup urine disease in Brazilian patients: variants and clinical phenotype heterogeneity.

Branched-chain amino acids Inborn errors of metabolism Isoleucine Leucine Maple syrup urine disease Valine

Journal

Orphanet journal of rare diseases
ISSN: 1750-1172
Titre abrégé: Orphanet J Rare Dis
Pays: England
ID NLM: 101266602

Informations de publication

Date de publication:
01 11 2020
Historique:
received: 18 11 2019
accepted: 15 10 2020
entrez: 2 11 2020
pubmed: 3 11 2020
medline: 22 6 2021
Statut: epublish

Résumé

Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disease caused by deficient activity of the branched-chain α-keto acid dehydrogenase (BCKD) enzymatic complex. BCKD is a mitochondrial complex encoded by BCKDHA, BCKDHB, DBT, and DLD genes. MSUD is predominantly caused by Variants in BCKDHA, BCKDHB, and DBT genes encoding the E1α, E1β, and E2 subunits of BCKD complex, respectively. The aim of this study was to characterize the genetic basis of MSUD by identifying the point variants in BCKDHA, BCKDHB, and DBT genes in a cohort of Brazilian MSUD patients and to describe their phenotypic heterogeneity. It is a descriptive cross-sectional study with 21 MSUD patients involving molecular genotyping by Sanger sequencing. Eight new variants predicted as pathogenic were found between 30 variants (damaging and non-damaging) identified in the 21 patients analyzed: one in the BCKDHA gene (p.Tyr120Ter); five in the BCKDHB gene (p.Gly131Val, p.Glu146Glnfs * 13, p.Phe149Cysfs * 9, p.Cys207Phe, and p.Lys211Asn); and two in the DBT gene (p.Glu148Ter and p.Glu417Val). Seventeen pathogenic variants were previously described and five variants showed no pathogenicity according to in silico analysis. Given that most of the patients received late diagnoses, the study results do not allow us to state that the molecular features of MSUD variant phenotypes are predictive of clinical severity.

Sections du résumé

BACKGROUND
Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disease caused by deficient activity of the branched-chain α-keto acid dehydrogenase (BCKD) enzymatic complex. BCKD is a mitochondrial complex encoded by BCKDHA, BCKDHB, DBT, and DLD genes. MSUD is predominantly caused by Variants in BCKDHA, BCKDHB, and DBT genes encoding the E1α, E1β, and E2 subunits of BCKD complex, respectively. The aim of this study was to characterize the genetic basis of MSUD by identifying the point variants in BCKDHA, BCKDHB, and DBT genes in a cohort of Brazilian MSUD patients and to describe their phenotypic heterogeneity. It is a descriptive cross-sectional study with 21 MSUD patients involving molecular genotyping by Sanger sequencing.
RESULTS
Eight new variants predicted as pathogenic were found between 30 variants (damaging and non-damaging) identified in the 21 patients analyzed: one in the BCKDHA gene (p.Tyr120Ter); five in the BCKDHB gene (p.Gly131Val, p.Glu146Glnfs * 13, p.Phe149Cysfs * 9, p.Cys207Phe, and p.Lys211Asn); and two in the DBT gene (p.Glu148Ter and p.Glu417Val). Seventeen pathogenic variants were previously described and five variants showed no pathogenicity according to in silico analysis.
CONCLUSION
Given that most of the patients received late diagnoses, the study results do not allow us to state that the molecular features of MSUD variant phenotypes are predictive of clinical severity.

Identifiants

pubmed: 33131499
doi: 10.1186/s13023-020-01590-7
pii: 10.1186/s13023-020-01590-7
pmc: PMC7603684
doi:

Substances chimiques

3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide) EC 1.2.4.4

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

309

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Auteurs

Ana Vitoria Barban Margutti (AVB)

Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av., 3900 - HC Criança - off D506, Ribeirão Prêto, SP, 14049-900, Brazil.

Wilson Araújo Silva (WA)

Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
National Institute of Science and Technology in Stem Cell, and Cell Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Center for Medical Genomics at Clinics Hospital of the Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

Daniel Fantozzi Garcia (DF)

Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
National Institute of Science and Technology in Stem Cell, and Cell Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto, SP, Brazil.

Greice Andreotti de Molfetta (GA)

Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
National Institute of Science and Technology in Stem Cell, and Cell Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Center for Medical Genomics at Clinics Hospital of the Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

Adriana Aparecida Marques (AA)

National Institute of Science and Technology in Stem Cell, and Cell Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto, SP, Brazil.

Tatiana Amorim (T)

Associação de Pais e Amigos dos Excepcionais of Salvador, Salvador, BA, Brazil.
Department of Life Sciences, Bahia State University, Salvador, BA, Brazil.

Vânia Mesquita Gadelha Prazeres (VMG)

Federal University of Amazonas, Manaus, AM, Brazil.

Raquel Tavares Boy da Silva (RT)

Department of Pediatrics, Medical Sciences School, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.

Irene Kazue Miura (IK)

Sírio-Libanês Hospital, São Paulo, SP, Brazil.

João Seda Neto (J)

Sírio-Libanês Hospital, São Paulo, SP, Brazil.

Emerson de Santana Santos (ES)

Department of Medicine, Federal University of Sergipe, São Cristóvão, SE, Brazil.

Mara Lúcia Schmitz Ferreira Santos (MLSF)

Pequeno Príncipe Hospital, Curitiba, PR, Brazil.

Charles Marques Lourenço (CM)

Medical School, Estácio University Center of Ribeirão Preto, Ribeirão Preto, SP, Brazil.

Tássia Tonon (T)

Posgraduate Programme in Medicine - Medical Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.

Fernanda Sperb-Ludwig (F)

Department of Genetics, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.
BRAIN Laboratory (Basic Research and Advanced Investigations in Neurosciences), Clinics Hospital of Porto Alegre, Porto Alegre, RS, Brazil.

Carolina Fischinger Moura de Souza (CFM)

Medical Genetics Service, Clinics Hospital of Porto Alegre, Department of Genetics, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.

Ida Vanessa Döederlein Schwartz (IVD)

Medical Genetics Service, Clinics Hospital of Porto Alegre, Department of Genetics, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.

José Simon Camelo (JS)

Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av., 3900 - HC Criança - off D506, Ribeirão Prêto, SP, 14049-900, Brazil. jscamelo@fmrp.usp.br.

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