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对7例巴西患者中3-甲基多巴作为芳香族L-氨基酸脱羧酶缺乏症生物标志物的评估。

Evaluation of 3--methyldopa as a biomarker for aromatic L-amino acid decarboxylase deficiency in 7 Brazilian cases.

作者信息

Kubaski Francyne, Herbst Zackary M, Pereira Danilo A A, Silva Camilo, Chen Christine, Hwu Paul W L, van der Linden Helio, Lourenço Charles M, Giugliani Roberto

机构信息

PPGBM, UFRGS, Porto Alegre, Brazil.

Medical Genetics Service, HCPA, Porto Alegre, Brazil.

出版信息

Mol Genet Metab Rep. 2021 Mar 13;27:100744. doi: 10.1016/j.ymgmr.2021.100744. eCollection 2021 Jun.

Abstract

Aromatic L-amino acid decarboxylase (AADCD) deficiency is an autosomal recessive neurometabolic disorder, caused by biallelic mutations in the gene, that impairs the synthesis or metabolism of neurotransmitters leading to severe motor dysfunction. The main clinical signs are oculogyric crisis, hypotonia, hypokinesia, and dystonia. The biochemical diagnosis can be performed in cerebrospinal fluid by neurotransmitter analysis, which requires an invasive lumbar puncture, and the sample needs to be shipped frozen to a reference laboratory, usually across a country border. Measurement of AADC activity in plasma is also possible, but available in a few labs globally. 3--methyldopa (3-OMD) is a catabolic product of L-dopa and it is elevated in patients with AADC deficiency. The quantification of 3-OMD can be performed in dried blood spots (DBS), a sample that could be shipped at room temperature. 3-OMD levels of AADCD patients and controls were quantified in DBS by liquid chromatography tandem mass spectrometry. DBS samples from 7 Brazilian patients previously diagnosed with AADCD were used to validate the 3-OMD quantification as a screening procedure for this condition. All AADCD patients had at least a four-fold increase of 3-OMD. Thus, 3-OMD seems to be a reliable marker for AADCD, with potential use also in the newborn screening of this disease.

摘要

芳香族L-氨基酸脱羧酶(AADCD)缺乏症是一种常染色体隐性神经代谢障碍疾病,由该基因的双等位基因突变引起,会损害神经递质的合成或代谢,导致严重的运动功能障碍。主要临床症状为动眼危象、肌张力减退、运动功能减退和肌张力障碍。生化诊断可通过对脑脊液进行神经递质分析来进行,这需要进行侵入性腰椎穿刺,且样本需要冷冻运输至参考实验室,通常是跨国运输。也可以在血浆中测量AADC活性,但全球只有少数实验室能够进行。3-甲基多巴(3-OMD)是左旋多巴的分解代谢产物,在AADC缺乏症患者中会升高。3-OMD的定量分析可在干血斑(DBS)中进行,干血斑样本可在室温下运输。通过液相色谱串联质谱法对AADCD患者和对照的DBS样本中的3-OMD水平进行了定量分析。来自7名先前被诊断为AADCD的巴西患者的DBS样本被用于验证将3-OMD定量分析作为该病筛查程序的有效性。所有AADCD患者的3-OMD水平至少增加了四倍。因此,3-OMD似乎是AADCD的一个可靠标志物,在该病的新生儿筛查中也可能具有潜在用途。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e7/7973244/a30195ab6beb/gr1.jpg

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