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1.
J Helminthol ; 94: e5, 2018 Oct 29.
Article in English | MEDLINE | ID: mdl-30369336

ABSTRACT

A total of 1840 brine shrimps (Artemia franciscana) were examined for cestode larvae at monthly intervals between November 2015 and June 2016. Of these, 663 (36.03%) specimens were infected with cysticercoids of seven cestode species in numbers between one and sixteen. During the first four months of examination, the percentage of infected shrimps was low but rose significantly with increasing temperatures in March, reaching maximum values in May. Flamingolepis liguloides and Flamingolepis flamingo showed the highest prevalence overall, at 25.3 and 10.7%, respectively. The intensity of infection was 1-10 and 1-4 cysticercoids, respectively. Eurycestus avoceti, Wardium stellorae, Gynandrotaenia stammeri, Anomotaenia tringae and Confluaria podicipina occurred at lower prevalence of 4.5, 3.2, 1.7, 0.3 and 0.05%, respectively. Up to four species were detected in one host.


Subject(s)
Artemia/parasitology , Cestoda/isolation & purification , Lakes/parasitology , Shellfish/parasitology , Animals , Cestoda/classification , Larva/classification , United Arab Emirates
2.
Phytochem Anal ; 29(5): 507-515, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29601658

ABSTRACT

INTRODUCTION: Cannabis sativa L. (cannabis) is utilised as a therapeutic and recreational drug. With the legalisation of cannabis in many countries and the anticipated regulation of potency that will accompany legalisation, analytical testing facilities will require a broadly applicable, quantitative, high throughput method to meet increased demand. Current analytical methods for the biologically active components of cannabis (phytocannabinoids) suffer from low throughput and/or an incomplete complement of relevant phytocannabinoids. OBJECTIVE: To develop a rapid, quantitative and broadly applicable liquid chromatography-tandem mass spectrometry analytical method for 11 phytocannabinoids in cannabis with acidic and neutral character. METHODOLOGY: Bulk diffusion coefficients were calculated using the Taylor-Aris open tubular method, with four reference compounds used to validate the experimental set-up. Three columns were quantitatively evaluated using van Deemter plots and fit-to-purpose performance metrics. Low (1.2 µL2 ) and standard (3.6 µL2 ) extra-column variance ultra-high pressure liquid chromatography (UPLC) configurations were contrasted. Method performance was demonstrated with methanolic cannabis flower extracts. RESULTS: Bulk diffusion coefficients and van Deemter plots for 11 phytocannabinoids are reported. The developed chromatographic method includes the challenging Δ8 /Δ9 -tetrahydrocannabinol isobars and, at 6.5 min, is faster than existing methods targeting similar panels of biologically active phytocannabinoids. CONCLUSIONS: The bulk diffusion coefficients and van Deemter curves informed the development of a rapid quantitative method and will facilitate potential expansion to include additional compounds, including synthetic cannabinoids. The developed method can be implemented with low or standard extra-column variance UPLC configurations.


Subject(s)
Cannabinoids/chemistry , Cannabis/chemistry , Chromatography, Liquid/methods , Phytochemicals/chemistry , Tandem Mass Spectrometry/methods
3.
J Inherit Metab Dis ; 37(3): 415-20, 2014 May.
Article in English | MEDLINE | ID: mdl-24500076

ABSTRACT

Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive, multiple congenital anomaly syndrome with cognitive impairment and a distinct behavioral phenotype that includes autistic features. SLOS is caused by a defect in 3ß-hydroxysterol Δ(7)-reductase which leads to decreased cholesterol levels and elevated cholesterol precursors, specifically 7- and 8-dehydrocholesterol. However, the pathological processes contributing to the neurological abnormalities in SLOS have not been defined. In view of prior data suggesting defects in SLOS in vesicular release and given the association of altered serotonin metabolism with autism, we were interested in measuring neurotransmitter metabolite levels in SLOS to assess their potential to be used as biomarkers in therapeutic trials. We measured cerebral spinal fluid levels of serotonin and dopamine metabolites, 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA) respectively, in 21 SLOS subjects. Results were correlated with the SLOS anatomical severity score, Aberrant Behavior Checklist scores and concurrent sterol biochemistry. Cerebral spinal fluid (CSF) levels of both 5HIAA and HVA were significantly reduced in SLOS subjects. In individual patients, the levels of both 5HIAA and HVA were reduced to a similar degree. CSF neurotransmitter metabolite levels did not correlate with either CSF sterols or behavioral measures. This is the first study demonstrating decreased levels of CSF neurotransmitter metabolites in SLOS. We propose that decreased levels of neurotransmitters in SLOS are caused by a sterol-related defect in synaptic vesicle formation and that CSF 5HIAA and HVA will be useful biomarkers in development of future therapeutic trials.


Subject(s)
Homovanillic Acid/cerebrospinal fluid , Hydroxyindoleacetic Acid/cerebrospinal fluid , Smith-Lemli-Opitz Syndrome/cerebrospinal fluid , Adolescent , Child , Child, Preschool , Cholesterol/administration & dosage , Cholesterol/cerebrospinal fluid , Cross-Over Studies , Female , Humans , Male , Smith-Lemli-Opitz Syndrome/physiopathology , Synaptic Vesicles/physiology
4.
J Fish Biol ; 79(5): 1376-82, 2011 Nov.
Article in English | MEDLINE | ID: mdl-22026614

ABSTRACT

A zebra shark, Stegostoma fasciatum, held in captivity at the Burj Al Arab aquarium, produced embryos and pups in the absence of a male. A total of 15 pups were produced from eggs laid within the aquarium over a period of four consecutive years commencing 2007. Parthenogenesis was confirmed through DNA analysis for three pups sampled during the first two consecutive egg cycles and is presumed to be the method of reproduction responsible thereafter.


Subject(s)
Parthenogenesis/physiology , Sharks/physiology , Animals , Female , Genotype , Male , Microsatellite Repeats/genetics , Parthenogenesis/genetics , Sharks/genetics , Time Factors
5.
J Inherit Metab Dis ; 32(1): 65-72, 2009 Feb.
Article in English | MEDLINE | ID: mdl-18949578

ABSTRACT

Rabies is a fatal viral encephalitis characterized by a clinically acute and progressive course. With rare exceptions, there is a discrepancy between clinical outcome and frank histological alterations in rabies. Investigators have postulated that rabies virus may modify neurotransmission through occupancy of cellular receptors or alteration of ion channels. We took advantage of these observations to improvise a successful therapy for rabies. The Milwaukee protocol ( www.mcw.edu/rabies ) was further modified to treat two German patients. We measured pterins and monoamine neurotransmitter metabolites in the CSF of patients with rabies by HPLC with electrochemical or fluorescent detection. We report loss of tetrahydrobiopterin (BH(4)) and associated pathological decrease of dopaminergic and serotoninergic neurotransmission in three successive patients with rabies. CSF levels of BH(4) and neurotransmitter metabolites increased in two patients who were supplemented. Our findings support the long-standing speculation of modified neurotransmission in the pathogenesis of rabies, but by another mechanism. Brain turnover of dopamine and serotonin is reduced following rabies-acquired BH(4) deficiency. Neuronal nitric oxide synthase is BH(4)-dependent and may also be involved, possibly causing cerebrovascular insufficiency in one patient. This work must be carefully replicated in animal models and future patients. We are cautiously optimistic at the prospect of readily available, metabolically specific, enteral therapy for rabies.


Subject(s)
Biopterins/analogs & derivatives , Phenylketonurias/complications , Rabies/complications , Adolescent , Adult , Biopterins/deficiency , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Movement Disorders/diagnosis , Movement Disorders/etiology , Rabies/diagnosis , Rabies/transmission , Speech Disorders/diagnosis , Speech Disorders/etiology
6.
Dev Biol (Basel) ; 131: 367-75, 2008.
Article in English | MEDLINE | ID: mdl-18634498

ABSTRACT

In 2004, a teenager survived bat-associated rabies through the Milwaukee protocol (MP). This survivor and another patient with dog-associated rabies were found to have developed deficiencies of tetrahydrobiopterin (BH4) and associated neurotransmitters. BH4 is also essential for neuronal nitric oxide synthase (nNOS), so rabies is predicted to cause constriction of cerebral arteries. We assume that rabies virus, which almost exclusively targets neurons, would disproportionately affect cerebral over systemic perfusion by disrupting nNOS and lead to generalised cerebral artery spasm. Cranial artery vasospasm, therefore, was actively sought in two rabies patients, with the intention to specifically treat with BH4 and L-arginine when necessary. Flow velocities and resistive (RI) or pulsatility indices (PI) of middle cerebral arteries (MCA) were obtained by transcranial doppler ultrasound (TCD). A survival analysis of 8 attempts at the MP is presented. Of these, two cases are reported here. The first case is one child with bat-associated rabies who developed severe bilateral MCAspasm on hospital day (HD)-10 that responded to very low dose (0.2 mcg/kg/min) nitroprusside. The second case, a child with dog-associated rabies, developed spasm of MCA on HD-6 that responded to 6 mg/kg/day BH4. A second spasm with high RI (without cerebral oedema or increased intracranial pressure) responded to 20 mg/kg/day BH4 and 0.5 g/kg/dose L-arginine. Review of the TCD of the first child showed a similar second spasm seven days after first episode. Cerebral artery vasospasm occurred in the two children with rabies, but was clinically silent by standard monitoring. Spasm responded to drugs directed at the NOS pathway. Animal models for treatment of rabies are sorely needed to evaluate therapy.


Subject(s)
Cerebral Arteries/pathology , Chiroptera/virology , Nitric Oxide Synthase/metabolism , Rabies/pathology , Vasospasm, Intracranial/pathology , Animals , Arginine/therapeutic use , Biopterins/analogs & derivatives , Biopterins/therapeutic use , Blood Flow Velocity , Cerebral Arteries/drug effects , Cerebrovascular Circulation , Child , Dog Diseases/transmission , Dogs , Humans , Nitroprusside/therapeutic use , Rabies/drug therapy , Rabies/transmission , Rabies/veterinary , Treatment Outcome , Ultrasonography, Doppler, Transcranial/methods , Vasospasm, Intracranial/drug therapy , Vasospasm, Intracranial/virology , Zoonoses
7.
Mol Genet Metab ; 91(4): 374-8, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17533144

ABSTRACT

Aromatic L-amino acid decarboxylase deficiency is a rare neurotransmitter defect leading to serotonin, dopamine and norepinephrine deficiency. Affected individuals usually present in infancy with severe developmental delay, oculogyric crises and extrapyramidal movements. We present the clinical, molecular and biochemical features of a pair of siblings who presented with fatigability, hypersomnolence and dystonia and who showed excellent response to treatment. Analysis of CSF biogenic amines, plasma AADC levels and direct sequencing of the DDC gene was performed. CSF catecholamine metabolites were reduced, with elevation of 3-O-methyldopa. Plasma AADC activity was undetectable in both siblings, and decreased in their carrier parents. One missense mutation (853C>T) was found in exon 8, and a donor splice site mutation was found in the intron after exon 6 (IVS6+4A>T). Both siblings showed excellent response to MAO inhibitor and dopamine agonist treatment. This report expands the clinical spectrum of AADC deficiency and contributes to the knowledge of the genotype and phenotype correlation for the DDC gene. It is important to recognize the milder phenotypes of the disease as these patients might respond well to therapy.


Subject(s)
Aromatic-L-Amino-Acid Decarboxylases/deficiency , Aromatic-L-Amino-Acid Decarboxylases/genetics , Mutation, Missense , Amino Acid Sequence , Amino Acid Substitution , Apgar Score , Biogenic Amines/cerebrospinal fluid , Catecholamines/cerebrospinal fluid , Female , Humans , Infant , Molecular Sequence Data , Phenotype , Siblings
8.
J Inherit Metab Dis ; 30(2): 256-62, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17242981

ABSTRACT

Tetrahydrobiopterin (BH4) is an essential cofactor for all isoforms of nitric oxide synthase. While it is well established that BH4 deficiency states are associated with impairment of dopamine, serotonin and phenylalanine metabolism, less is known with regard to the effects of deficiency of the cofactor upon nitric oxide (NO) metabolism. In this study, we have evaluated the effects of partial BH4 deficiency upon (a) tissue availability of the antioxidant glutathione, (b) basal NO production and (c) NO generation following exposure to lipopolysaccharide (LPS), which is known to increase expression of the inducible form of nitric oxide synthase. Using the hph-1 mouse, which displays a partial BH4 deficiency owing to impaired activity of GTP cyclohydrolase, we report decreased levels of glutathione in brain and kidney and evidence for decreased basal generation of nitric oxide in the periphery (as judged by the plasma nitrate plus nitrite concentration). Following LPS administration, peripheral NO generation increases. However, the concentration of plasma nitrate plus nitrite achieved was significantly decreased in the hph-1 mouse. Furthermore, LPS administration caused loss of glutathione in both wild-type and hph-1 liver and kidney. It is concluded that cofactor replacement, sufficient to fully correct a cellular BH4 deficiency, may be of benefit to patients with inborn errors of BH4 metabolism.


Subject(s)
Biopterins/analogs & derivatives , Carrier Proteins/genetics , GTP Cyclohydrolase/deficiency , Glutathione/metabolism , Mutation , Nitric Oxide/metabolism , Animals , Biological Availability , Biopterins/deficiency , Biopterins/metabolism , Brain/metabolism , Kidney/metabolism , Lipopolysaccharides/pharmacology , Liver/metabolism , Metabolism, Inborn Errors/blood , Metabolism, Inborn Errors/metabolism , Mice , Nitrates/blood , Nitrites/blood , Osmolar Concentration , Polycomb Repressive Complex 1
10.
Vet Immunol Immunopathol ; 105(3-4): 301-15, 2005 May 15.
Article in English | MEDLINE | ID: mdl-15808308

ABSTRACT

Peyer's patches of the intestinal mucosa are essential for host defense and immune regulation in the enteric system. To better understand molecular mechanisms of Peyer's patch function, we have screened for differentially expressed genes specific to Peyer's patch. cDNA libraries were created from normal Peyer's patch, immune stimulated Peyer's patch, and pooled cDNA subtracted with fibroblast RNA. From the subtracted library, 3687 expressed sequence tags (ESTs), representing 2414 unique nucleotide sequences, were isolated, identified by BLAST searches against public databases, and spotted onto a microarray for gene expression profiling. Approximately 30% of these ESTs BLAST to genes of unknown function and 20% have no known homology in the public databases (novel genes). Of the novel genes, 70% are expressed in normal immune tissues by microarray analysis, suggesting that at least 371 of the unidentified EST sequences from the subtracted library are novel porcine genes and can now be further characterized to determine their function in the porcine Peyer's patch. We surmise that the products of these genes participate in biochemical and cellular functions related to the unique immunological and gastroenterological functions of the small intestine. The BLAST and gene ontology information for each of the subtracted library EST sequences, the normal and immune stimulated libraries, and the microarray are all valuable resources that will facilitate further examination of the biological function of porcine Peyer's patch tissue.


Subject(s)
Gene Expression Profiling/veterinary , Gene Expression/physiology , Peyer's Patches/metabolism , Swine/immunology , Animals , Expressed Sequence Tags , Oligonucleotide Array Sequence Analysis/veterinary , Swine/genetics
11.
Brain Res Mol Brain Res ; 135(1-2): 112-21, 2005 Apr 27.
Article in English | MEDLINE | ID: mdl-15857674

ABSTRACT

The tremor rat is a spontaneous epilepsy model with a seizure phenotype caused by a deletion in the aspartoacylase (ASPA) gene. The absence of ASPA expression in these animals results in undetectable levels of enzyme activity and the accumulation of the substrate N-acetyl-aspartate (NAA) in brain, leading to generalized myelin vacuolation and severe motor and cognitive impairment. In support of human gene therapy for CD, recombinant adeno-associated viral vector (AAV-2) expressing ASPA was stereotactically delivered to the tremor rat brain and effects on the mutant phenotype were measured. AAV-ASPA gene transfer resulted in elevated aspartoacylase bioactivity compared to untreated mutant animals and elicited a significant decrease in the pathologically elevated whole-brain NAA levels. Assessment of motor function via quantitative rotorod testing demonstrated that rats injected with AAV-ASPA significantly improved on tests of balance and coordinated locomotion compared to animals receiving control vectors. This study provides evidence that AAV-2-mediated aspartoacylase gene transfer to the brain improves biochemical and behavioral deficits in tremor rat mutants (tm/tm) and supports the rationale of human gene transfer for Canavan disease.


Subject(s)
Amidohydrolases/metabolism , Aspartic Acid/analogs & derivatives , Tremor/therapy , Amidohydrolases/genetics , Amidohydrolases/therapeutic use , Analysis of Variance , Animals , Aspartic Acid/metabolism , Behavior, Animal , Brain/drug effects , Brain/virology , Canavan Disease/complications , Canavan Disease/virology , Dependovirus/genetics , Dependovirus/physiology , Disease Models, Animal , Gene Transfer Techniques , Genetic Vectors/physiology , Glial Fibrillary Acidic Protein/metabolism , Green Fluorescent Proteins/metabolism , Immunohistochemistry/methods , Locomotion/physiology , Phosphopyruvate Hydratase/metabolism , Psychomotor Performance/physiology , Rats , Rats, Mutant Strains , Recombinant Proteins/therapeutic use , Tremor/etiology , Tremor/genetics
12.
Neurology ; 64(6): 1088-90, 2005 Mar 22.
Article in English | MEDLINE | ID: mdl-15781839

ABSTRACT

The authors describe a 6-year-old girl with developmental delay, psychomotor regression, seizures, mental retardation, and autistic features associated with low CSF levels of 5-methyltetrahydrofolate, the biologically active form of folates in CSF and blood. Folate and B12 levels were normal in peripheral tissues, suggesting cerebral folate deficiency. Treatment with folinic acid corrected CSF abnormalities and improved motor skills.


Subject(s)
Autistic Disorder/drug therapy , Cerebral Cortex/drug effects , Cerebral Cortex/growth & development , Developmental Disabilities/drug therapy , Folic Acid Deficiency/drug therapy , Leucovorin/administration & dosage , Seizures/drug therapy , Adaptation, Physiological/drug effects , Adaptation, Physiological/physiology , Autistic Disorder/cerebrospinal fluid , Autistic Disorder/etiology , Cerebral Cortex/metabolism , Child , Developmental Disabilities/cerebrospinal fluid , Developmental Disabilities/etiology , Disease Progression , Female , Folic Acid/metabolism , Folic Acid Deficiency/cerebrospinal fluid , Folic Acid Deficiency/physiopathology , Genetic Predisposition to Disease , Humans , Intellectual Disability/drug therapy , Intellectual Disability/etiology , Intellectual Disability/metabolism , Mutation/genetics , Recovery of Function/drug effects , Recovery of Function/physiology , Reduced Folate Carrier Protein/genetics , Seizures/cerebrospinal fluid , Seizures/etiology , Tetrahydrofolates/cerebrospinal fluid , Transcription Factors/genetics , Treatment Outcome
13.
Mol Genet Metab ; 83(3): 207-12, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15542391

ABSTRACT

Phenylalanine loading has been proposed as a diagnostic test for autosomal dominant DRD (dopa-responsive dystonia), and recently, a phenylalanine/tyrosine (phe/tyr) ratio of 7.5 after 4 h was reported as diagnostic of DRD. To test the utility of this test in another sample with DRD, we administered an oral challenge of phenylalanine (100 mg/kg) to 11 individuals with DRD and one non-manifesting gene carrier. Only 6/12 had a 4 h phe/tyr ratio of greater than 7.5, suggesting that additional parameters must be set to avoid missing the diagnosis of DRD, including the need for the plasma phenylalanine to reach a minimum level 600 in order for the test to be valid. We propose that in cases where this minimum plasma phenylalanine level is not reached, plasma tetrahydrobiopterin should be measured or alternatively other symptomatic family members should be screened.


Subject(s)
Dystonic Disorders/diagnosis , Phenylalanine , Tyrosine , Adolescent , Adult , Aged , Aged, 80 and over , DNA Mutational Analysis , DNA Primers , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Pedigree , Phenylalanine/administration & dosage , Phenylalanine/blood , Phenylalanine Hydroxylase/genetics , Sequence Analysis, DNA , Time Factors , Tyrosine/blood
14.
Neurology ; 62(10): 1872-4, 2004 May 25.
Article in English | MEDLINE | ID: mdl-15159499

ABSTRACT

Two girls and one boy are described, with severe infantile parkinsonism-dystonia. This syndrome is usually caused by endogenous dopamine deficiency but in these patients was associated with elevated dopamine metabolites in CSF and an unusual eye movement disorder: ocular flutter together with saccade initiation failure. Pyramidal tract signs also emerged in the course of the disease in two patients. This combination of symptoms and biochemical findings suggests a unique pathogenic mechanism.


Subject(s)
Dopamine/cerebrospinal fluid , Dystonic Disorders/cerebrospinal fluid , Homovanillic Acid/cerebrospinal fluid , Ocular Motility Disorders/cerebrospinal fluid , Parkinson Disease/cerebrospinal fluid , Dopamine/urine , Dystonic Disorders/diagnostic imaging , Female , Homovanillic Acid/urine , Humans , Hydroxyindoleacetic Acid/cerebrospinal fluid , Infant, Newborn , Male , Ocular Motility Disorders/diagnostic imaging , Parkinson Disease/diagnostic imaging , Reflex, Abnormal , Saccades , Syndrome , Tomography, Emission-Computed, Single-Photon
15.
J Inherit Metab Dis ; 27(2): 165-78, 2004.
Article in English | MEDLINE | ID: mdl-15159647

ABSTRACT

Hypoxanthine-guanine phosphoribosyltransferase (HPRT) is an enzyme that catalyses the conversion of hypoxanthine and guanine into their respective nucleotides. Inherited deficiency of the enzyme is associated with a loss of striatal dopamine in both mouse and man. Although HPRT is not directly involved in the metabolism of dopamine, it contributes to the supply of GTP, which is used in the first and rate-limiting step in the synthesis of tetrahydrobiopterin (BH4). Since BH4 is required as a cofactor for tyrosine hydroxylase in the synthesis of dopamine, any limitation in the supply of GTP could interfere with the synthesis of dopamine. The current studies were designed to address the hypothesis that the reduced striatal dopamine in mice with HPRT deficiency results from reduced availability of BH4. The mutant mice had small reductions in striatal BH4, with normal BH4 levels in other brain regions. Liver BH4 was normal in HPRT-deficient mutant mice, and a phenylalanine challenge test failed to reveal any evidence for impaired hepatic phenylalanine hydroxylase, another BH4-dependent enzyme. Although striatal BH4 content is not normal, supplementation with BH4 or L-dopa failed to correct the striatal dopamine deficiency of the mutant mice, suggesting that BH4 limitation is not responsible for the dopamine loss.


Subject(s)
Biopterins/analogs & derivatives , Biopterins/deficiency , Dopamine/biosynthesis , Dopamine/metabolism , Hypoxanthine Phosphoribosyltransferase/genetics , Lesch-Nyhan Syndrome/metabolism , Animals , Biopterins/pharmacology , Corpus Striatum/metabolism , Disease Models, Animal , Dopamine Agents/pharmacology , Lesch-Nyhan Syndrome/drug therapy , Lesch-Nyhan Syndrome/genetics , Levodopa/pharmacology , Male , Mice , Mice, Inbred C57BL , Mice, Mutant Strains , Phenylalanine/blood , Phenylalanine/pharmacology , Tyrosine/blood
16.
Neurology ; 62(7): 1058-65, 2004 Apr 13.
Article in English | MEDLINE | ID: mdl-15079002

ABSTRACT

BACKGROUND: Deficiency of aromatic L-amino acid decarboxylase (AADC) is associated with severe developmental delay, oculogyric crises (OGC), and autonomic dysfunction. Treatment with dopamine agonists and MAO inhibitors is beneficial, yet long-term prognosis is unclear. OBJECTIVE: To delineate the clinical and molecular spectrum of AADC deficiency, its management, and long-term follow-up. RESULTS: The authors present six patients with AADC deficiency and review seven cases from the literature. All patients showed reduced catecholamine metabolites and elevation of 3-O-methyldopa in CSF. Residual plasma AADC activity ranged from undetectable to 8% of normal. Mutational spectrum was heterogeneous. All patients presented with hypotonia, hypokinesia, OGC, and signs of autonomic dysfunction since early life. Diurnal fluctuation or improvement of symptoms after sleep were noted in half of the patients. Treatment response was variable. Two groups of patients were detected: Group I (five males) responded to treatment and made developmental progress. Group II (one male, five females) responded poorly to treatment, and often developed drug-induced dyskinesias. CONCLUSIONS: The molecular and clinical spectrum of AADC deficiency is heterogeneous. Two groups, one with predominant male sex and favorable response to treatment, and the other with predominant female sex and poor response to treatment, can be discerned.


Subject(s)
Amino Acid Metabolism, Inborn Errors/diagnosis , Amino Acid Metabolism, Inborn Errors/drug therapy , Aromatic-L-Amino-Acid Decarboxylases/deficiency , Tyrosine/analogs & derivatives , Adolescent , Amino Acid Metabolism, Inborn Errors/genetics , Aromatic-L-Amino-Acid Decarboxylases/blood , Aromatic-L-Amino-Acid Decarboxylases/genetics , Child , Child, Preschool , Disease Progression , Dopamine Agonists/therapeutic use , Female , Homovanillic Acid/cerebrospinal fluid , Humans , Hydroxyindoleacetic Acid/cerebrospinal fluid , Infant , Male , Monoamine Oxidase Inhibitors/therapeutic use , Prognosis , Sex Factors , Treatment Outcome , Tyrosine/cerebrospinal fluid , Vitamin B 6/therapeutic use
18.
Neuropediatrics ; 33(4): 203-8, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12368991

ABSTRACT

Aromatic L-amino acid decarboxylase (AADC - E.C. 4.1.1.28) converts L-dopa to dopamine and 5-hydroxytryptophan to serotonin. Inherited deficiency of this enzyme leads to decreased brain levels of these neurotransmitters. Clinically this results in the development of a progressive neurometabolic disorder characterized by severe hypotonia, dystonic and choreoathetoid movements, oculogyric crises, and hypothermia from infancy. Here we describe the clinical, biochemical and molecular details of two affected brothers, one of whom, despite the lack of AADC, presented with hyperdopaminuria. In addition, we detail his reactions to treatment with dopaminergic agonists, monoamine oxidase inhibitors and pyridoxine.


Subject(s)
Aromatic-L-Amino-Acid Decarboxylases/drug effects , Aromatic-L-Amino-Acid Decarboxylases/deficiency , Dopamine/urine , Metabolism, Inborn Errors/drug therapy , Metabolism, Inborn Errors/urine , Aromatic-L-Amino-Acid Decarboxylases/genetics , Child , Child, Preschool , Dopamine/genetics , Humans , Infant, Newborn , Male , Metabolism, Inborn Errors/genetics
19.
Neuropediatrics ; 33(3): 113-7, 2002 Jun.
Article in English | MEDLINE | ID: mdl-12200739

ABSTRACT

Aromatic L-amino acid decarboxylase (AADC) is a vitamin B 6 requiring enzyme involved in the biosynthesis of the neurotransmitters dopamine (DA) and serotonin. Lack of AADC leads to a combined deficiency of the catecholamines DA, norepinephrine (NE), epinephrine (E) as well as of serotonin. Here we describe premature twins who presented with severe seizures, myoclonus, rotatory eye movements and sudden clonic contractions. The patients showed an improvement of the clonic contractions under vitamin B 6 supplementation but died in the third week of life. In CSF and urine a biochemical pattern indicative of AADC deficiency was revealed. Concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) were decreased, in association with increased concentrations of 3-ortho-methyldopa (3-OMD) in CSF and significantly increased vanillactic acid in urine. The AADC enzyme substrates L-dopa and 5-hydroxytryptophan (5-HTP) were elevated in CSF. Elevated concentrations of threonine as well as of an unidentified compound in CSF rounded off the biochemical pattern. AADC activity was found to be increased in plasma and deficient in the liver. Molecular studies effectively ruled out a genetic defect in the AADC gene. The basis for the epileptic encephalopathy in the twins may be located in the metabolism of vitamin B 6 and remains to be defined.


Subject(s)
Aromatic-L-Amino-Acid Decarboxylases/blood , Aromatic-L-Amino-Acid Decarboxylases/deficiency , Brain Damage, Chronic/blood , Brain Damage, Chronic/genetics , Epilepsy/blood , Epilepsy/genetics , Twins , Aromatic-L-Amino-Acid Decarboxylases/genetics , Brain Damage, Chronic/cerebrospinal fluid , Diagnosis, Differential , Epilepsy/cerebrospinal fluid , Fatal Outcome , Humans , Infant, Newborn
20.
Mov Disord ; 16(1): 144-9, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11215576

ABSTRACT

PURPOSE: To evaluate the role of CNS dopaminergic systems in Restless Legs Syndrome (RLS), homovanillic acid (HVA), tetrahydrobiopterin (BH4), and neopterin (NEOP), were assayed in CSF from RLS patients. The serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA), was also measured. METHODS: CSF was taken from 16 RLS patients after 2 weeks off medication and from 14 control subjects. The CSF metabolites were determined using HPLC techniques. RESULTS: There was no significant difference in HVA or 5-HIAA, but NEOP and BH4 were higher in RLS patients. The RLS group was significantly older than the control group (64.2 +/- 9.2 years vs. 51.4 +/- 6.3 years; P < 0.001). A multiple regression analysis showed a strong correlation between age and 5-HIAA (r = 0.46, P = 0.04) and between age and NEOP (r = 0.61, P < 0.01). To eliminate the potential error created by the age difference between groups, an age-adjusted subgroup of RLS and control subjects were compared. There was still no difference found for HVA; however, 5-HIAA was now significantly lower (P < 0.01) in the RLS subgroup. Age-adjustment eliminated the differences previously found for NEOP, (P = 0.12), but BH4 continued to remain higher in the RLS group (P < 0.01). CONCLUSION: Differences in CSF HVA concentrations were not found. The changes in 5-HIAA and BH4 are of unclear clinical significance and require further assessment with appropriate age-matched controls.


Subject(s)
Biopterins/analogs & derivatives , Biopterins/cerebrospinal fluid , Dopamine/cerebrospinal fluid , Restless Legs Syndrome/cerebrospinal fluid , Serotonin/cerebrospinal fluid , Age Factors , Brain/metabolism , Female , Homovanillic Acid/cerebrospinal fluid , Humans , Hydroxyindoleacetic Acid/cerebrospinal fluid , Male , Middle Aged , Neopterin/cerebrospinal fluid , Spinal Cord/metabolism
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